Do TNF Inhibitors Increase Cancer Recurrence Risk?

Tumor necrosis factor (TNF) inhibitors were not associated with an increased risk for cancer recurrence among patients with rheumatoid arthritis (RA), according to the findings of a recent study. 

The population-based cohort study included 467 patients who initiated TNF inhibitors between 2001 and 2015. Patients who were diagnosed with cancer were matched to 2164 biologic-naïve patients with RA with the same cancer. First cancer recurrence was assessed as the primary outcome. Hazard ratios (HR) were calculated and adjusted for time, cancer type, and whether the cancer was invasive or in situ.

A total of 42 patients receiving TNF inhibitors (9%) and 155 patients not receiving biologics (7.2%) experienced cancer recurrences (HR 1.06, 95% CI 0.73-1.54). “Hazard ratios were close to 1 in analyses of patient subsets matched on cancer stage or with similar time from index cancer diagnosis to the start of TNF [inhibitors] treatment, as well as in unmatched analyses. Several CIs had upper limits close to 2,” the researchers said. 

“The findings suggest that TNF [inhibitor] treatment is not associated with increased risk for cancer recurrence in patients with RA,” the researchers concluded. “Although meaningful risk increases could not be ruled out completely.”

 Reference

Raaschou P, Söderling J, Turesson C, Askling J. Tumor necrosis factor inhibitors and cancer recurrence in Swedish patients with rheumatoid arthritis: a nationwide population-based cohort study [published online August 14, 2018]. Ann Intern Med. doi:10.7326/M17-2812