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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Lymphoma in patients treated with anti-TNF: results of the 3-year prospective French RATIO registry</title>
<author><name sortKey="Mariette, Xavier" sort="Mariette, Xavier" uniqKey="Mariette X" first="Xavier" last="Mariette">Xavier Mariette</name>
<affiliation><nlm:aff id="A1">Service de rhumatologie<institution>AP-HP</institution>
<institution>Hôpital Bicêtre</institution>
<institution>Université Paris Sud - Paris XI</institution>
<addr-line>Le Kremlin-Bicêtre,FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Tubach, Florence" sort="Tubach, Florence" uniqKey="Tubach F" first="Florence" last="Tubach">Florence Tubach</name>
<affiliation><nlm:aff id="A2">Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques<institution>INSERM : U738</institution>
<institution>Université Paris-Diderot - Paris VII</institution>
<addr-line>Faculté de médecine Paris 7 16, Rue Henri Huchard 75018 Paris,FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bagheri, Haleh" sort="Bagheri, Haleh" uniqKey="Bagheri H" first="Haleh" last="Bagheri">Haleh Bagheri</name>
<affiliation><nlm:aff id="A3">Unité de Pharmacoépidémiologie : Evaluation de l'exposition et du risque médicamenteux<institution>Université Paul Sabatier - Toulouse III : EA3696</institution>
<institution>CHU Toulouse</institution>
<addr-line>F-31000 Toulouse,FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bardet, Michel" sort="Bardet, Michel" uniqKey="Bardet M" first="Michel" last="Bardet">Michel Bardet</name>
<affiliation><nlm:aff id="A4">Service de médecine interne et rhumatologie<institution>Hôpital de la source</institution>
<institution>CHR Orléans</institution>
<addr-line>Orleans,FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Berthelot, Jean Marie" sort="Berthelot, Jean Marie" uniqKey="Berthelot J" first="Jean-Marie" last="Berthelot">Jean-Marie Berthelot</name>
<affiliation><nlm:aff id="A5">Service de Rhumatologie<institution>CHU Nantes</institution>
<institution>Hôtel-Dieu</institution>
<addr-line>Nantes,FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gaudin, Philippe" sort="Gaudin, Philippe" uniqKey="Gaudin P" first="Philippe" last="Gaudin">Philippe Gaudin</name>
<affiliation><nlm:aff id="A6">Service de Rhumatologie<institution>Hôpital Michallon</institution>
<institution>CHU Grenoble</institution>
<institution>Université Joseph Fourier - Grenoble I</institution>
<addr-line>Grenoble,FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Heresbach, Denis" sort="Heresbach, Denis" uniqKey="Heresbach D" first="Denis" last="Heresbach">Denis Heresbach</name>
<affiliation><nlm:aff id="A7">Service de Gastroentérologie<institution>CHU Rennes</institution>
<institution>Hôpital Pontchaillou</institution>
<addr-line>2 Rue Henri le Guilloux 35033 Rennes,FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Martin, Antoine" sort="Martin, Antoine" uniqKey="Martin A" first="Antoine" last="Martin">Antoine Martin</name>
<affiliation><nlm:aff id="A8">Service de Rhumatologie<institution>Hôpital de St Brieuc</institution>
<addr-line>St Brieuc,FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Schaeverbeke, Thierry" sort="Schaeverbeke, Thierry" uniqKey="Schaeverbeke T" first="Thierry" last="Schaeverbeke">Thierry Schaeverbeke</name>
<affiliation><nlm:aff id="A9">Service de rhumatologie<institution>CHU Bordeaux</institution>
<addr-line>FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Salmon, Dominique" sort="Salmon, Dominique" uniqKey="Salmon D" first="Dominique" last="Salmon">Dominique Salmon</name>
<affiliation><nlm:aff id="A10">Service de médecine interne<institution>AP-HP</institution>
<institution>Hôpital Cochin</institution>
<institution>Université Paris Descartes</institution>
<addr-line>27 rue du Faubourg Saint Antoine, 75679 Paris Cedex 14, France,FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lemann, Marc" sort="Lemann, Marc" uniqKey="Lemann M" first="Marc" last="Lemann">Marc Lemann</name>
<affiliation><nlm:aff id="A11">Service de gastro-entérologie<institution>AP-HP</institution>
<institution>Hôpital Saint-Louis</institution>
<addr-line>Paris, FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Hermine, Olivier" sort="Hermine, Olivier" uniqKey="Hermine O" first="Olivier" last="Hermine">Olivier Hermine</name>
<affiliation><nlm:aff id="A12">Service d'hématologie biologique<institution>AP-HP</institution>
<institution>Hôpital Necker - Enfants Malades</institution>
<institution>Université Paris Descartes</institution>
<addr-line>Paris,FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Raphael, Martine" sort="Raphael, Martine" uniqKey="Raphael M" first="Martine" last="Raphael">Martine Raphael</name>
<affiliation><nlm:aff id="A13">Laboratoire d'Hématologie<institution>AP-HP</institution>
<institution>Université Paris Sud - Paris XI</institution>
<institution>Hôpital Bicêtre</institution>
<addr-line>FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ravaud, Philippe" sort="Ravaud, Philippe" uniqKey="Ravaud P" first="Philippe" last="Ravaud">Philippe Ravaud</name>
<affiliation><nlm:aff id="A2">Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques<institution>INSERM : U738</institution>
<institution>Université Paris-Diderot - Paris VII</institution>
<addr-line>Faculté de médecine Paris 7 16, Rue Henri Huchard 75018 Paris,FR</addr-line>
</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">19828563</idno>
<idno type="pmc">2925048</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925048</idno>
<idno type="RBID">PMC:2925048</idno>
<idno type="doi">10.1136/ard.2009.117762</idno>
<date when="2009">2009</date>
<idno type="wicri:Area/Pmc/Corpus">000200</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Lymphoma in patients treated with anti-TNF: results of the 3-year prospective French RATIO registry</title>
<author><name sortKey="Mariette, Xavier" sort="Mariette, Xavier" uniqKey="Mariette X" first="Xavier" last="Mariette">Xavier Mariette</name>
<affiliation><nlm:aff id="A1">Service de rhumatologie<institution>AP-HP</institution>
<institution>Hôpital Bicêtre</institution>
<institution>Université Paris Sud - Paris XI</institution>
<addr-line>Le Kremlin-Bicêtre,FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Tubach, Florence" sort="Tubach, Florence" uniqKey="Tubach F" first="Florence" last="Tubach">Florence Tubach</name>
<affiliation><nlm:aff id="A2">Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques<institution>INSERM : U738</institution>
<institution>Université Paris-Diderot - Paris VII</institution>
<addr-line>Faculté de médecine Paris 7 16, Rue Henri Huchard 75018 Paris,FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bagheri, Haleh" sort="Bagheri, Haleh" uniqKey="Bagheri H" first="Haleh" last="Bagheri">Haleh Bagheri</name>
<affiliation><nlm:aff id="A3">Unité de Pharmacoépidémiologie : Evaluation de l'exposition et du risque médicamenteux<institution>Université Paul Sabatier - Toulouse III : EA3696</institution>
<institution>CHU Toulouse</institution>
<addr-line>F-31000 Toulouse,FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bardet, Michel" sort="Bardet, Michel" uniqKey="Bardet M" first="Michel" last="Bardet">Michel Bardet</name>
<affiliation><nlm:aff id="A4">Service de médecine interne et rhumatologie<institution>Hôpital de la source</institution>
<institution>CHR Orléans</institution>
<addr-line>Orleans,FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Berthelot, Jean Marie" sort="Berthelot, Jean Marie" uniqKey="Berthelot J" first="Jean-Marie" last="Berthelot">Jean-Marie Berthelot</name>
<affiliation><nlm:aff id="A5">Service de Rhumatologie<institution>CHU Nantes</institution>
<institution>Hôtel-Dieu</institution>
<addr-line>Nantes,FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gaudin, Philippe" sort="Gaudin, Philippe" uniqKey="Gaudin P" first="Philippe" last="Gaudin">Philippe Gaudin</name>
<affiliation><nlm:aff id="A6">Service de Rhumatologie<institution>Hôpital Michallon</institution>
<institution>CHU Grenoble</institution>
<institution>Université Joseph Fourier - Grenoble I</institution>
<addr-line>Grenoble,FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Heresbach, Denis" sort="Heresbach, Denis" uniqKey="Heresbach D" first="Denis" last="Heresbach">Denis Heresbach</name>
<affiliation><nlm:aff id="A7">Service de Gastroentérologie<institution>CHU Rennes</institution>
<institution>Hôpital Pontchaillou</institution>
<addr-line>2 Rue Henri le Guilloux 35033 Rennes,FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Martin, Antoine" sort="Martin, Antoine" uniqKey="Martin A" first="Antoine" last="Martin">Antoine Martin</name>
<affiliation><nlm:aff id="A8">Service de Rhumatologie<institution>Hôpital de St Brieuc</institution>
<addr-line>St Brieuc,FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Schaeverbeke, Thierry" sort="Schaeverbeke, Thierry" uniqKey="Schaeverbeke T" first="Thierry" last="Schaeverbeke">Thierry Schaeverbeke</name>
<affiliation><nlm:aff id="A9">Service de rhumatologie<institution>CHU Bordeaux</institution>
<addr-line>FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Salmon, Dominique" sort="Salmon, Dominique" uniqKey="Salmon D" first="Dominique" last="Salmon">Dominique Salmon</name>
<affiliation><nlm:aff id="A10">Service de médecine interne<institution>AP-HP</institution>
<institution>Hôpital Cochin</institution>
<institution>Université Paris Descartes</institution>
<addr-line>27 rue du Faubourg Saint Antoine, 75679 Paris Cedex 14, France,FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lemann, Marc" sort="Lemann, Marc" uniqKey="Lemann M" first="Marc" last="Lemann">Marc Lemann</name>
<affiliation><nlm:aff id="A11">Service de gastro-entérologie<institution>AP-HP</institution>
<institution>Hôpital Saint-Louis</institution>
<addr-line>Paris, FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Hermine, Olivier" sort="Hermine, Olivier" uniqKey="Hermine O" first="Olivier" last="Hermine">Olivier Hermine</name>
<affiliation><nlm:aff id="A12">Service d'hématologie biologique<institution>AP-HP</institution>
<institution>Hôpital Necker - Enfants Malades</institution>
<institution>Université Paris Descartes</institution>
<addr-line>Paris,FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Raphael, Martine" sort="Raphael, Martine" uniqKey="Raphael M" first="Martine" last="Raphael">Martine Raphael</name>
<affiliation><nlm:aff id="A13">Laboratoire d'Hématologie<institution>AP-HP</institution>
<institution>Université Paris Sud - Paris XI</institution>
<institution>Hôpital Bicêtre</institution>
<addr-line>FR</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ravaud, Philippe" sort="Ravaud, Philippe" uniqKey="Ravaud P" first="Philippe" last="Ravaud">Philippe Ravaud</name>
<affiliation><nlm:aff id="A2">Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques<institution>INSERM : U738</institution>
<institution>Université Paris-Diderot - Paris VII</institution>
<addr-line>Faculté de médecine Paris 7 16, Rue Henri Huchard 75018 Paris,FR</addr-line>
</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Annals of the Rheumatic Diseases</title>
<idno type="ISSN">0003-4967</idno>
<idno type="eISSN">1468-2060</idno>
<imprint><date when="2009">2009</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title>
<p id="P1">To describe cases of lymphoma associated with anti-TNF therapy, identify risk factors, estimate the incidence and compare risks for different anti-TNF agents.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">We designed a national prospective registry (RATIO) from 2004 to 2006, for collecting all cases of lymphoma in French patients receiving anti-TNF therapy, whatever the indication. We conducted a case-control analysis including two controls treated with anti-TNF per case and an incidence study of lymphoma with the French population used as reference..</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">We collected 38 cases of lymphoma, 31 non-Hodgkin’s lymphoma (NHL) (26 B-cell and 5 T-cell), 5 Hodgkin’s lymphoma (HL) and 2 Hodgkin’s-like lymphoma. Epstein-Barr virus (EBV) was detected in 2 of 2 Hodgkin’s-like lymphoma, 3 of 5 HL and one NHL. Patients receiving adalimumab or infliximab had a higher risk than those treated with etanercept: SIR = 4.1 (2.3–7.1) and 3.6 (2.3–5.6) versus 0.9 (0.4– 1.8). The exposure to adalimumab or infliximab versus etanercept was an independent risk factor for lymphoma in the case-control study: odds ratio=4.7 (1.3– 17.7) and 4.1 (1.4–12.5), respectively. The sex and age- adjusted incidence rate of lymphoma was 42.1 per 100,000 patient-years. The standardized incidence ratio (SIR) was 2.4 (95% confidence interval [CI] 1.7–3.2).</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P4">Some lymphomas associated with immunosuppression may occur in patients receiving anti TNF therapy, and the risk of lymphoma is higher with monoclonal-antibody therapy than with soluble-receptor therapy.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Ann Rheum Dis</journal-id>
<journal-title-group><journal-title>Annals of the Rheumatic Diseases</journal-title>
</journal-title-group>
<issn pub-type="ppub">0003-4967</issn>
<issn pub-type="epub">1468-2060</issn>
<publisher><publisher-name>BMJ Group</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">19828563</article-id>
<article-id pub-id-type="pmc">2925048</article-id>
<article-id pub-id-type="manuscript">HALMS431509</article-id>
<article-id pub-id-type="doi">10.1136/ard.2009.117762</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
<subj-group subj-group-type="subrepository"><subject>INSERM Subrepository</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group><article-title>Lymphoma in patients treated with anti-TNF: results of the 3-year prospective French RATIO registry</article-title>
<alt-title>Lymphoma complicating anti-TNF therapy</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Mariette</surname>
<given-names>Xavier</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref rid="FN1" ref-type="author-notes">*</xref>
<xref ref-type="author-notes" rid="FN2">#</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Tubach</surname>
<given-names>Florence</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="author-notes" rid="FN2">#</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bagheri</surname>
<given-names>Haleh</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bardet</surname>
<given-names>Michel</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Berthelot</surname>
<given-names>Jean-Marie</given-names>
</name>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gaudin</surname>
<given-names>Philippe</given-names>
</name>
<xref ref-type="aff" rid="A6">6</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Heresbach</surname>
<given-names>Denis</given-names>
</name>
<xref ref-type="aff" rid="A7">7</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Martin</surname>
<given-names>Antoine</given-names>
</name>
<xref ref-type="aff" rid="A8">8</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Schaeverbeke</surname>
<given-names>Thierry</given-names>
</name>
<xref ref-type="aff" rid="A9">9</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Salmon</surname>
<given-names>Dominique</given-names>
</name>
<xref ref-type="aff" rid="A10">10</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lemann</surname>
<given-names>Marc</given-names>
</name>
<xref ref-type="aff" rid="A11">11</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hermine</surname>
<given-names>Olivier</given-names>
</name>
<xref ref-type="aff" rid="A12">12</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Raphael</surname>
<given-names>Martine</given-names>
</name>
<xref ref-type="aff" rid="A13">13</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ravaud</surname>
<given-names>Philippe</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<on-behalf-of>for the RATIO group</on-behalf-of>
</contrib-group>
<aff id="A1"><label>1</label>
Service de rhumatologie<institution>AP-HP</institution>
<institution>Hôpital Bicêtre</institution>
<institution>Université Paris Sud - Paris XI</institution>
<addr-line>Le Kremlin-Bicêtre,FR</addr-line>
</aff>
<aff id="A2"><label>2</label>
Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques<institution>INSERM : U738</institution>
<institution>Université Paris-Diderot - Paris VII</institution>
<addr-line>Faculté de médecine Paris 7 16, Rue Henri Huchard 75018 Paris,FR</addr-line>
</aff>
<aff id="A3"><label>3</label>
Unité de Pharmacoépidémiologie : Evaluation de l'exposition et du risque médicamenteux<institution>Université Paul Sabatier - Toulouse III : EA3696</institution>
<institution>CHU Toulouse</institution>
<addr-line>F-31000 Toulouse,FR</addr-line>
</aff>
<aff id="A4"><label>4</label>
Service de médecine interne et rhumatologie<institution>Hôpital de la source</institution>
<institution>CHR Orléans</institution>
<addr-line>Orleans,FR</addr-line>
</aff>
<aff id="A5"><label>5</label>
Service de Rhumatologie<institution>CHU Nantes</institution>
<institution>Hôtel-Dieu</institution>
<addr-line>Nantes,FR</addr-line>
</aff>
<aff id="A6"><label>6</label>
Service de Rhumatologie<institution>Hôpital Michallon</institution>
<institution>CHU Grenoble</institution>
<institution>Université Joseph Fourier - Grenoble I</institution>
<addr-line>Grenoble,FR</addr-line>
</aff>
<aff id="A7"><label>7</label>
Service de Gastroentérologie<institution>CHU Rennes</institution>
<institution>Hôpital Pontchaillou</institution>
<addr-line>2 Rue Henri le Guilloux 35033 Rennes,FR</addr-line>
</aff>
<aff id="A8"><label>8</label>
Service de Rhumatologie<institution>Hôpital de St Brieuc</institution>
<addr-line>St Brieuc,FR</addr-line>
</aff>
<aff id="A9"><label>9</label>
Service de rhumatologie<institution>CHU Bordeaux</institution>
<addr-line>FR</addr-line>
</aff>
<aff id="A10"><label>10</label>
Service de médecine interne<institution>AP-HP</institution>
<institution>Hôpital Cochin</institution>
<institution>Université Paris Descartes</institution>
<addr-line>27 rue du Faubourg Saint Antoine, 75679 Paris Cedex 14, France,FR</addr-line>
</aff>
<aff id="A11"><label>11</label>
Service de gastro-entérologie<institution>AP-HP</institution>
<institution>Hôpital Saint-Louis</institution>
<addr-line>Paris, FR</addr-line>
</aff>
<aff id="A12"><label>12</label>
Service d'hématologie biologique<institution>AP-HP</institution>
<institution>Hôpital Necker - Enfants Malades</institution>
<institution>Université Paris Descartes</institution>
<addr-line>Paris,FR</addr-line>
</aff>
<aff id="A13"><label>13</label>
Laboratoire d'Hématologie<institution>AP-HP</institution>
<institution>Université Paris Sud - Paris XI</institution>
<institution>Hôpital Bicêtre</institution>
<addr-line>FR</addr-line>
</aff>
<author-notes><corresp id="FN1">* Correspondence should be adressed to: Pr Xavier MARIETTE <email>xavier.mariette@bct.ap-hop-paris.fr</email>
</corresp>
<fn id="FN2"><label>#</label>
<p>the two authors contributed equally to the work</p>
</fn>
</author-notes>
<pub-date pub-type="ppub"><month>2</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="epub"><day>14</day>
<month>10</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>23</day>
<month>8</month>
<year>2010</year>
</pub-date>
<volume>69</volume>
<issue>2</issue>
<fpage>400</fpage>
<lpage>408</lpage>
<abstract><sec id="S1"><title>Objective</title>
<p id="P1">To describe cases of lymphoma associated with anti-TNF therapy, identify risk factors, estimate the incidence and compare risks for different anti-TNF agents.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">We designed a national prospective registry (RATIO) from 2004 to 2006, for collecting all cases of lymphoma in French patients receiving anti-TNF therapy, whatever the indication. We conducted a case-control analysis including two controls treated with anti-TNF per case and an incidence study of lymphoma with the French population used as reference..</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">We collected 38 cases of lymphoma, 31 non-Hodgkin’s lymphoma (NHL) (26 B-cell and 5 T-cell), 5 Hodgkin’s lymphoma (HL) and 2 Hodgkin’s-like lymphoma. Epstein-Barr virus (EBV) was detected in 2 of 2 Hodgkin’s-like lymphoma, 3 of 5 HL and one NHL. Patients receiving adalimumab or infliximab had a higher risk than those treated with etanercept: SIR = 4.1 (2.3–7.1) and 3.6 (2.3–5.6) versus 0.9 (0.4– 1.8). The exposure to adalimumab or infliximab versus etanercept was an independent risk factor for lymphoma in the case-control study: odds ratio=4.7 (1.3– 17.7) and 4.1 (1.4–12.5), respectively. The sex and age- adjusted incidence rate of lymphoma was 42.1 per 100,000 patient-years. The standardized incidence ratio (SIR) was 2.4 (95% confidence interval [CI] 1.7–3.2).</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P4">Some lymphomas associated with immunosuppression may occur in patients receiving anti TNF therapy, and the risk of lymphoma is higher with monoclonal-antibody therapy than with soluble-receptor therapy.</p>
</sec>
</abstract>
<kwd-group kwd-group-type="MESH"><kwd>Aged</kwd>
<kwd>Antirheumatic Agents</kwd>
<kwd>adverse effects</kwd>
<kwd>therapeutic use</kwd>
<kwd>Arthritis</kwd>
<kwd>drug therapy</kwd>
<kwd>Epidemiologic Methods</kwd>
<kwd>Female</kwd>
<kwd>France</kwd>
<kwd>epidemiology</kwd>
<kwd>Humans</kwd>
<kwd>Immunocompromised Host</kwd>
<kwd>Immunosuppressive Agents</kwd>
<kwd>adverse effects</kwd>
<kwd>therapeutic use</kwd>
<kwd>Lymphoma</kwd>
<kwd>chemically induced</kwd>
<kwd>epidemiology</kwd>
<kwd>immunology</kwd>
<kwd>Male</kwd>
<kwd>Middle Aged</kwd>
<kwd>Registries</kwd>
<kwd>Tumor Necrosis Factor-alpha</kwd>
<kwd>antagonists & inhibitors</kwd>
</kwd-group>
<kwd-group kwd-group-type="Author"><kwd>Anti-TNF</kwd>
<kwd>Lymphoma</kwd>
<kwd>Safety</kwd>
<kwd>Rheumatoid arthritis</kwd>
<kwd>Spondylarthropathies</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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