LeHavreV1, Main, Merge, bibRecord, 000967

Lymphoma in patients treated with anti-TNF: results of the 3-year prospective French RATIO registry

Identifieur interne : 000967 ( Main/Merge ); précédent : 000966; suivant : 000968

Lymphoma in patients treated with anti-TNF: results of the 3-year prospective French RATIO registry

Auteurs : X. Mariette [France] ; F. Tubach [France] ; H. Bagheri [France] ; M. Bardet [France] ; J M Berthelot [France] ; P. Gaudin [France] ; D. Heresbach [France] ; A. Martin [France] ; T. Schaeverbeke [France] ; D. Salmon [France] ; M. Lemann [France] ; O. Hermine [France] ; M. Raphael [France] ; P. Ravaud [France]

Source :

Annals of the Rheumatic Diseases [ 0003-4967 ] ; 2010-02.

RBID : ISTEX:733F58FA17CA878BEB83478B8B10B3590B340E75

Abstract

Objective: To describe cases of lymphoma associated with anti-TNF therapy, identify risk factors, estimate the incidence and compare the risks for different anti-TNF agents. Methods: A national prospective registry was designed (Research Axed on Tolerance of bIOtherapies; RATIO) to collect all cases of lymphoma in French patients receiving anti-TNF therapy from 2004 to 2006, whatever the indication. A case–control analysis was conducted including two controls treated with anti-TNF per case and an incidence study of lymphoma with the French population was used as the reference. Results: 38 cases of lymphoma, 31 non-Hodgkin’s lymphoma (NHL) (26 B cell and five T cell), five Hodgkin’s lymphoma (HL) and two Hodgkin’s-like lymphoma were collected. Epstein–Barr virus was detected in both of two Hodgkin’s-like lymphoma, three of five HL and one NHL. Patients receiving adalimumab or infliximab had a higher risk than those treated with etanercept: standardised incidence ratio (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 SIR was 2.4 (95% CI 1.7 to 3.2). Conclusion: The two to threefold increased risk of lymphoma in patients receiving anti-TNF therapy is similar to that expected for such patients with severe inflammatory diseases. Some lymphomas associated with immunosuppression may occur, and the risk of lymphoma is higher with monoclonal-antibody therapy than with soluble-receptor therapy.

Url:

DOI: 10.1136/ard.2009.117762

Links to Exploration step

ISTEX:733F58FA17CA878BEB83478B8B10B3590B340E75

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<front><div type="abstract">Objective: To describe cases of lymphoma associated with anti-TNF therapy, identify risk factors, estimate the incidence and compare the risks for different anti-TNF agents. Methods: A national prospective registry was designed (Research Axed on Tolerance of bIOtherapies; RATIO) to collect all cases of lymphoma in French patients receiving anti-TNF therapy from 2004 to 2006, whatever the indication. A case–control analysis was conducted including two controls treated with anti-TNF per case and an incidence study of lymphoma with the French population was used as the reference. Results: 38 cases of lymphoma, 31 non-Hodgkin’s lymphoma (NHL) (26 B cell and five T cell), five Hodgkin’s lymphoma (HL) and two Hodgkin’s-like lymphoma were collected. Epstein–Barr virus was detected in both of two Hodgkin’s-like lymphoma, three of five HL and one NHL. Patients receiving adalimumab or infliximab had a higher risk than those treated with etanercept: standardised incidence ratio (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 SIR was 2.4 (95% CI 1.7 to 3.2). Conclusion: The two to threefold increased risk of lymphoma in patients receiving anti-TNF therapy is similar to that expected for such patients with severe inflammatory diseases. Some lymphomas associated with immunosuppression may occur, and the risk of lymphoma is higher with monoclonal-antibody therapy than with soluble-receptor therapy.</div>
</front>
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<author><name sortKey="Mariette, X" sort="Mariette, X" uniqKey="Mariette X" first="X" last="Mariette">X. Mariette</name>
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<author><name sortKey="Salmon, D" sort="Salmon, D" uniqKey="Salmon D" first="D" last="Salmon">D. Salmon</name>
<affiliation wicri:level="1"><country xml:lang="fr">France</country>
<wicri:regionArea>AP-HP, Hôpital Cochin, Service de médecine interne, Université Paris V, Paris</wicri:regionArea>
<placeName><settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Lemann, M" sort="Lemann, M" uniqKey="Lemann M" first="M" last="Lemann">M. Lemann</name>
<affiliation wicri:level="1"><country xml:lang="fr">France</country>
<wicri:regionArea>AP-HP, Hôpital Saint Louis, Service de gastro-entérologie, Université Paris 7, Paris</wicri:regionArea>
<placeName><settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Hermine, O" sort="Hermine, O" uniqKey="Hermine O" first="O" last="Hermine">O. Hermine</name>
<affiliation wicri:level="1"><country xml:lang="fr">France</country>
<wicri:regionArea>AP-HP, Hôpital Necker, Service d’hématologie, CNRS UMR 8143, Université Paris V, Paris</wicri:regionArea>
<placeName><settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Raphael, M" sort="Raphael, M" uniqKey="Raphael M" first="M" last="Raphael">M. Raphael</name>
<affiliation wicri:level="1"><country xml:lang="fr">France</country>
<wicri:regionArea>AP-HP, Hôpital Bicêtre, Laboratoire d’hématologie, Université Paris-Sud 11, Le Kremlin-Bicêtre</wicri:regionArea>
<wicri:noRegion>Le Kremlin-Bicêtre</wicri:noRegion>
<wicri:noRegion>Le Kremlin-Bicêtre</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Ravaud, P" sort="Ravaud, P" uniqKey="Ravaud P" first="P" last="Ravaud">P. Ravaud</name>
<affiliation wicri:level="1"><country xml:lang="fr">France</country>
<wicri:regionArea>Université Paris 7 Denis Diderot, UFR de médecine; INSERM, U738; AP-HP, Hôpital Bichat, Département d’Epidémiologie, Biostatistique et Recherche Clinique, Paris</wicri:regionArea>
<placeName><settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
</analytic>
<monogr></monogr>
<series><title level="j">Annals of the Rheumatic Diseases</title>
<title level="j" type="abbrev">Ann Rheum Dis</title>
<idno type="ISSN">0003-4967</idno>
<idno type="eISSN">1468-2060</idno>
<imprint><publisher>BMJ Publishing Group Ltd and European League Against Rheumatism</publisher>
<date type="published" when="2010-02">2010-02</date>
<biblScope unit="volume">69</biblScope>
<biblScope unit="issue">2</biblScope>
<biblScope unit="page" from="400">400</biblScope>
</imprint>
<idno type="ISSN">0003-4967</idno>
</series>
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<idno type="DOI">10.1136/ard.2009.117762</idno>
<idno type="href">annrheumdis-69-400.pdf</idno>
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<front><div type="abstract">Objective: To describe cases of lymphoma associated with anti-TNF therapy, identify risk factors, estimate the incidence and compare the risks for different anti-TNF agents. Methods: A national prospective registry was designed (Research Axed on Tolerance of bIOtherapies; RATIO) to collect all cases of lymphoma in French patients receiving anti-TNF therapy from 2004 to 2006, whatever the indication. A case–control analysis was conducted including two controls treated with anti-TNF per case and an incidence study of lymphoma with the French population was used as the reference. Results: 38 cases of lymphoma, 31 non-Hodgkin’s lymphoma (NHL) (26 B cell and five T cell), five Hodgkin’s lymphoma (HL) and two Hodgkin’s-like lymphoma were collected. Epstein–Barr virus was detected in both of two Hodgkin’s-like lymphoma, three of five HL and one NHL. Patients receiving adalimumab or infliximab had a higher risk than those treated with etanercept: standardised incidence ratio (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 SIR was 2.4 (95% CI 1.7 to 3.2). Conclusion: The two to threefold increased risk of lymphoma in patients receiving anti-TNF therapy is similar to that expected for such patients with severe inflammatory diseases. Some lymphomas associated with immunosuppression may occur, and the risk of lymphoma is higher with monoclonal-antibody therapy than with soluble-receptor therapy.</div>
</front>
</TEI>
</ISTEX>
<PMC><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>
<wicri:noCountry code="subfield">R</wicri:noCountry>
</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>
<wicri:noCountry code="subfield">R</wicri:noCountry>
</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>
<wicri:noCountry code="subfield">R</wicri:noCountry>
</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>
<wicri:noCountry code="subfield">R</wicri:noCountry>
</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>
<wicri:noCountry code="subfield">R</wicri:noCountry>
</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>
<wicri:noCountry code="subfield">R</wicri:noCountry>
</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>
<wicri:noCountry code="subfield">R</wicri:noCountry>
</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>
<wicri:noCountry code="subfield">R</wicri:noCountry>
</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>
<wicri:noCountry code="subfield">R</wicri:noCountry>
</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>
<wicri:noCountry code="subfield">FR</wicri:noCountry>
</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>
<wicri:noCountry code="subfield">R</wicri:noCountry>
</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>
<wicri:noCountry code="subfield">R</wicri:noCountry>
</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>
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<idno type="wicri:doubleKey">0003-4967:2009:Mariette X:lymphoma:in:patients</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>
<wicri:noCountry code="subfield">R</wicri:noCountry>
</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>
<wicri:noCountry code="subfield">R</wicri:noCountry>
</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>
<wicri:noCountry code="subfield">R</wicri:noCountry>
</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>
<wicri:noCountry code="subfield">R</wicri:noCountry>
</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>
<wicri:noCountry code="subfield">R</wicri:noCountry>
</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>
<wicri:noCountry code="subfield">R</wicri:noCountry>
</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>
<wicri:noCountry code="subfield">R</wicri:noCountry>
</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>
<wicri:noCountry code="subfield">R</wicri:noCountry>
</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>
<wicri:noCountry code="subfield">R</wicri:noCountry>
</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>
<wicri:noCountry code="subfield">FR</wicri:noCountry>
</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>
<wicri:noCountry code="subfield">R</wicri:noCountry>
</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>
<wicri:noCountry code="subfield">R</wicri:noCountry>
</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>
</double>
</record>

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Lymphoma in patients treated with anti-TNF: results of the 3-year prospective French RATIO registry

Lymphoma in patients treated with anti-TNF: results of the 3-year prospective French RATIO registry

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