Increased lymphoma risk with anti-TNF agents and/or thiopurines in IBD
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Increased lymphoma risk with anti-TNF agents and/or thiopurines in IBD The use of anti-tumour necrosis factor (TNF) agents, alone or combined with thiopurines, in patients with inflammatory bowel disease (IBD) is associated with an increased risk of lymphoma. This is the main finding of a systematic review with meta-analysis conducted by researchers from France to investigate the comparative risk of lymphoma with anti-TNF agents, given alone or combined with thiopurines, in patients with IBD. The review included 4 observational cohort studies comprising a total of 261 689 adults with IBD. Of these patients, 30 463 had received infliximab, 61 794 adalimumab, 16 250 combination therapy and 165 867 neither of these. Compared with patients who were not exposed to anti-TNF agents and thiopurines (control group), the risk of lymphoma was significantly higher for those who had received anti-TNF monotherapy (pooled incidence-rate ratio [IRR] of lymphoma 1.52 [95% CI: 1.06–2.19]). The pooled IRR of lymphoma for those exposed to thiopurine monotherapy versus control was 2.23 (95% CI: 1.79–2.79). For combination therapy versus control, the pooled IRR of lymphoma was 3.71 (95% CI: 2.30–6.00). The risk of lymphoma was significantly higher with combination therapy versus anti-TNF monotherapy (pooled IRR 2.49 [95% CI: 1.39–4.47]) and versus thiopurine monotherapy (pooled IRR 1.70 [95% CI: 1.03–2.81]). The risk of lymphoma did not differ between anti-TNF monotherapy and thiopurine monotherapy (pooled IRR 0.72). Chupin A, et al. Systematic review with meta-analysis: comparative risk of lymphoma with anti-tumour necrosis factor agents and/or thiopurines in patients with inflammatory 803501747 bowel disease. Alimentary Pharmacology and Therapeutics : 25 Aug 2020. Available from: URL: http://doi.org/10.1111/apt.16050
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Reactions 19 Sep 2020 No. 1822
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