接受肿瘤坏死因子抑制剂治疗的炎症性关节炎患者的血液系统恶性肿瘤风险：来自HUR-BIO注册研究的真实数据。
Hematologic Malignancy Risk in Inflammatory Arthritis Patients Treated with TNF Inhibitors: The Real-Life Data from the HUR-BIO Registry.
作者信息
Duran Emine, Ozturk Zeynep Ozge, Bilgin Emre, Büyükaşık Yahya, Dizdar Omer, Yardimci Gozde Kubra, Farisogullari Bayram, Özsoy Zehra, Ayan Gizem, Uzun Gullu Sandal, Ekici Mustafa, Unaldi Erdinc, Kilic Levent, Akdoğan Ali, Karadag Omer, Bilgen Şule Apraş, Kiraz Sedat, Kalyoncu Umut, Ertenli Ali Ihsan
机构信息
Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Sihhiye, 06100, Ankara, Turkey.
Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
出版信息
Rheumatol Ther. 2023 Aug;10(4):969-981. doi: 10.1007/s40744-023-00563-z. Epub 2023 Jun 9.
INTRODUCTION
This study aimed to assess the incidence of hematologic malignancy (HM) among inflammatory arthritis (IA) patients receiving tumor necrosis factor inhibitors (TNFi) compared with the general Turkish population.
METHODS
HUR-BIO (Hacettepe University Rheumatology Biologic Registry) is a single-center biological disease-modifying anti-rheumatic drug (bDMARD) registry since 2005. Patients with IA, including rheumatoid arthritis, spondyloarthritis, or psoriatic arthritis who had at least one visit after the TNFi were screened from 2005 to November 2021. Standardized incidence rates (SIR) were calculated after adjustment for age and gender and compared with the 2017 Turkish National Cancer Registry (TNCR).
RESULTS
Of the 6139 patients registered in the HUR-BIO, 5355 used any TNFi at least once. The median follow-up duration was 2.6 years for patients receiving TNFi. Thirteen patients developed a HM on follow-up. In these patients, the median age at the IA onset was 38 (range, 26-67), and the median age at the HM diagnosis was 55.5 (range, 38-76). Patients using TNFi had an increased HM incidence (SIR 4.23, 95% confidence interval (CI) 2.35-7.05). Ten patients with HM were under 65 years of age. In this group, there was a higher incidence of HM in both men (SIR 5.15, 95% CI 1.88-11.43) and women (SIR 4.76, 95% CI 1.74-10.55).
CONCLUSIONS
The risk of HMs in inflammatory arthritis patients receiving TNFi was four times higher than in the general Turkish population.
引言
本研究旨在评估接受肿瘤坏死因子抑制剂（TNFi）治疗的炎性关节炎（IA）患者中血液系统恶性肿瘤（HM）的发病率，并与土耳其普通人群进行比较。
方法
HUR-BIO（哈杰泰佩大学风湿病生物制剂登记处）自2005年起为单中心生物性疾病改善抗风湿药物（bDMARD）登记处。从2005年至2021年11月，对IA患者进行筛查，这些患者包括类风湿关节炎、脊柱关节炎或银屑病关节炎患者，且在接受TNFi治疗后至少有一次就诊记录。在对年龄和性别进行调整后计算标准化发病率（SIR），并与2017年土耳其国家癌症登记处（TNCR）的数据进行比较。
结果
在HUR-BIO登记的6139例患者中，5355例至少使用过一次TNFi。接受TNFi治疗的患者中位随访时间为2.6年。随访期间有13例患者发生了HM。在这些患者中，IA发病的中位年龄为38岁（范围26 - 67岁），HM诊断时的中位年龄为55.5岁（范围38 - 76岁）。使用TNFi的患者HM发病率增加（SIR 4.23，95%置信区间（CI）2.35 - 7.05）。10例HM患者年龄在65岁以下。在该组中，男性（SIR 5.15，95% CI 1.88 - 11.43）和女性（SIR 4.76，95% CI 1.74 - 10.55）的HM发病率均较高。
结论
接受TNFi治疗的炎性关节炎患者发生HM的风险比土耳其普通人群高四倍。
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