Anti–Tumor Necrosis Factor Agents: Continued Evidence of Low Cancer Risk

Douglas K. Rex, MD

Reassuring findings for clinicians and their patients with IBD who take these drugs

Recent study findings suggest that thiopurine use increases the risk for lymphoma and nonmelanoma skin cancers in patients with inflammatory bowel disease (IBD) but that use of anti–tumor necrosis factor (anti-TNF) agents does not increase cancer risk in these patients.

In the current nationwide, register-based cohort study, investigators assessed the risk for cancer from exposure to anti-TNF agents. The cohort comprised 56,146 patients aged ≥15 years with IBD who were residents of Denmark between 1999 and 2012. Results were as follows:

Total follow-up was 489,433 person-years (median, 9.3 years).

A total of 4553 patients (8.1%) were exposed to anti-TNF agents (median follow-up after exposure, 3.7 years).

Risk for cancer was 1.8% in exposed patients and 6.7% in unexposed patients (adjusted relative risk, 1.07; 95% confidence interval, 0.85–1.36).

After adjustment for azathioprine exposure, the relative risk for skin cancer was 1.02, and the RR for hematopoietic cancers including lymphoma was 0.90.

Citation(s):

Andersen NN et al. Association between tumor necrosis factor-α antagonists and risk of cancer in patients with inflammatory bowel disease. JAMA 2014 Jun 18; 311:2406.