Is there an increased risk of lymphoma and malignancies under anti-TNF therapy in IBD?

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Tumour necrosis factor alpha (TNF-alpha) inhibitors ensure valuable treatment advantages for patients with inflammatory bowel diseases (IBD) by offering a more targeted anti-inflammatory therapy. In contrast, there is concern that it might increase the risk of long-term complications including infections and the risk for malignancies and non-Hodgkin's lymphoma (NHL). Although the results from hospital- and population-based studies are conflictive, the results of a meta-analysis suggest that patients receiving purine analogues for the treatment of IBD have a lymphoma risk 4-fold higher than expected. Analyses of lymphoma risk in patients receiving biologic agents directed against tumour necrosis factor-alpha are confounded by concomitant use of immunosuppressive agents in most of these patients. Nevertheless, in a recent meta-analysis, a 3-fold increased risk of NHL was found in patients with previous immunomodulator exposure, while scattered case reports point to the potentially increased risk of a rare form of NHL (Hepatosplenic T-cell lymphoma) with the use of azathioprine-anti-TNF combination. The absolute rate of these events remains, however low and should be weighed against the substantial benefits associated with treatment. In contrast, data obtained from observational studies and registries did not show an increased risk for solid tumours or lymphoma in patients with anti-TNF exposure. The aim of this review is to summarize the available evidence on the association between malignancy and anti-TNF treatment in IBD.

Original languageEnglish
Pages (from-to)179-186
Number of pages8
JournalCurrent Drug Targets
Volume11
Issue number2
DOIs
Publication statusPublished - Feb 2010

Fingerprint

Inflammatory Bowel Diseases
Lymphoma
Neoplasms
Non-Hodgkin's Lymphoma
Therapeutics
Meta-Analysis
Tumor Necrosis Factor-alpha
T-cells
T-Cell Lymphoma
Azathioprine
Immunologic Factors
Biological Factors
Immunosuppressive Agents
Observational Studies
Registries
Tumors
Anti-Inflammatory Agents
Infection
Population

Keywords

  • Adalimumab
  • Anti-TNF
  • CD
  • Certolizumab
  • HSTCL
  • IBD
  • Infliximab
  • Lymphoma
  • Malignancy
  • UC

ASJC Scopus subject areas

  • Drug Discovery
  • Pharmacology
  • Clinical Biochemistry
  • Molecular Medicine

Cite this

Is there an increased risk of lymphoma and malignancies under anti-TNF therapy in IBD? / Lakatos, P.; Miheller, P.

In: Current Drug Targets, Vol. 11, No. 2, 02.2010, p. 179-186.

Research output: Contribution to journalArticle

@article{2a4751cc73b049748e06ba3b1c123fbc,
title = "Is there an increased risk of lymphoma and malignancies under anti-TNF therapy in IBD?",
abstract = "Tumour necrosis factor alpha (TNF-alpha) inhibitors ensure valuable treatment advantages for patients with inflammatory bowel diseases (IBD) by offering a more targeted anti-inflammatory therapy. In contrast, there is concern that it might increase the risk of long-term complications including infections and the risk for malignancies and non-Hodgkin's lymphoma (NHL). Although the results from hospital- and population-based studies are conflictive, the results of a meta-analysis suggest that patients receiving purine analogues for the treatment of IBD have a lymphoma risk 4-fold higher than expected. Analyses of lymphoma risk in patients receiving biologic agents directed against tumour necrosis factor-alpha are confounded by concomitant use of immunosuppressive agents in most of these patients. Nevertheless, in a recent meta-analysis, a 3-fold increased risk of NHL was found in patients with previous immunomodulator exposure, while scattered case reports point to the potentially increased risk of a rare form of NHL (Hepatosplenic T-cell lymphoma) with the use of azathioprine-anti-TNF combination. The absolute rate of these events remains, however low and should be weighed against the substantial benefits associated with treatment. In contrast, data obtained from observational studies and registries did not show an increased risk for solid tumours or lymphoma in patients with anti-TNF exposure. The aim of this review is to summarize the available evidence on the association between malignancy and anti-TNF treatment in IBD.",
keywords = "Adalimumab, Anti-TNF, CD, Certolizumab, HSTCL, IBD, Infliximab, Lymphoma, Malignancy, UC",
author = "P. Lakatos and P. Miheller",
year = "2010",
month = "2",
doi = "10.2174/138945010790309867",
language = "English",
volume = "11",
pages = "179--186",
journal = "Current Drug Targets",
issn = "1389-4501",
publisher = "Bentham Science Publishers B.V.",
number = "2",

}

TY - JOUR

T1 - Is there an increased risk of lymphoma and malignancies under anti-TNF therapy in IBD?

AU - Lakatos, P.

AU - Miheller, P.

PY - 2010/2

Y1 - 2010/2

N2 - Tumour necrosis factor alpha (TNF-alpha) inhibitors ensure valuable treatment advantages for patients with inflammatory bowel diseases (IBD) by offering a more targeted anti-inflammatory therapy. In contrast, there is concern that it might increase the risk of long-term complications including infections and the risk for malignancies and non-Hodgkin's lymphoma (NHL). Although the results from hospital- and population-based studies are conflictive, the results of a meta-analysis suggest that patients receiving purine analogues for the treatment of IBD have a lymphoma risk 4-fold higher than expected. Analyses of lymphoma risk in patients receiving biologic agents directed against tumour necrosis factor-alpha are confounded by concomitant use of immunosuppressive agents in most of these patients. Nevertheless, in a recent meta-analysis, a 3-fold increased risk of NHL was found in patients with previous immunomodulator exposure, while scattered case reports point to the potentially increased risk of a rare form of NHL (Hepatosplenic T-cell lymphoma) with the use of azathioprine-anti-TNF combination. The absolute rate of these events remains, however low and should be weighed against the substantial benefits associated with treatment. In contrast, data obtained from observational studies and registries did not show an increased risk for solid tumours or lymphoma in patients with anti-TNF exposure. The aim of this review is to summarize the available evidence on the association between malignancy and anti-TNF treatment in IBD.

AB - Tumour necrosis factor alpha (TNF-alpha) inhibitors ensure valuable treatment advantages for patients with inflammatory bowel diseases (IBD) by offering a more targeted anti-inflammatory therapy. In contrast, there is concern that it might increase the risk of long-term complications including infections and the risk for malignancies and non-Hodgkin's lymphoma (NHL). Although the results from hospital- and population-based studies are conflictive, the results of a meta-analysis suggest that patients receiving purine analogues for the treatment of IBD have a lymphoma risk 4-fold higher than expected. Analyses of lymphoma risk in patients receiving biologic agents directed against tumour necrosis factor-alpha are confounded by concomitant use of immunosuppressive agents in most of these patients. Nevertheless, in a recent meta-analysis, a 3-fold increased risk of NHL was found in patients with previous immunomodulator exposure, while scattered case reports point to the potentially increased risk of a rare form of NHL (Hepatosplenic T-cell lymphoma) with the use of azathioprine-anti-TNF combination. The absolute rate of these events remains, however low and should be weighed against the substantial benefits associated with treatment. In contrast, data obtained from observational studies and registries did not show an increased risk for solid tumours or lymphoma in patients with anti-TNF exposure. The aim of this review is to summarize the available evidence on the association between malignancy and anti-TNF treatment in IBD.

KW - Adalimumab

KW - Anti-TNF

KW - CD

KW - Certolizumab

KW - HSTCL

KW - IBD

KW - Infliximab

KW - Lymphoma

KW - Malignancy

KW - UC

UR - http://www.scopus.com/inward/record.url?scp=77950833122&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77950833122&partnerID=8YFLogxK

U2 - 10.2174/138945010790309867

DO - 10.2174/138945010790309867

M3 - Article

C2 - 20210767

AN - SCOPUS:77950833122

VL - 11

SP - 179

EP - 186

JO - Current Drug Targets

JF - Current Drug Targets

SN - 1389-4501

IS - 2

ER -