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Risk of malignancies in patients with inflammatory bowel disease treated with thiopurines or anti-TNF alpha antibodies

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Organization
Abstract
Purpose We aimed to analyse malignancy rates and predictors for the development of malignancies in a large German inflammatory bowel disease (IBD) cohort treated with thiopurines and/or anti-tumour necrosis factor (TNF) antibodies. Methods De novo malignancies in 666 thiopurine-treated and/or anti-TNF-treated IBD patients were analysed. Patients (n = 262) were treated with thiopurines alone and never exposed to anti-TNF antibodies (TP group). In addition, patients (n = 404) were exposed to anti-TNF antibodies (TNF+ group) with no (7.4%), discontinued (80.4%) or continued (12.1%) thiopurine therapy. Results In the TP group, 20 malignancies were observed in 18 patients compared with 8 malignancies in 7 patients in the TNF+ group (hazard ratio 4.15; 95% CI 1.82-9.44; p = 0.0007; univariate Cox regression). Moreover, 18.2% of all patients in the TP group >= 50 years of age developed a malignancy, compared with 3.8% of all patients <50 years of age (p = 0.0008). In the TNF+ group, 6.5% of all patients >= 50 years of age developed malignancies compared with 0.3% of all patients < 50 years of age (p = 0.0007). In both groups combined, thiopurine treatment duration >= 4 years was associated with the risk for skin cancer (p = 0.0024) and lymphoma (p = 0.0005). Conclusions Our data demonstrate an increased risk for the development of malignancies in IBD patients treated with thiopurines in comparison with patients treated with anti-TNF antibodies with or without thiopurines. Copyright (C) 2014 John Wiley & Sons, Ltd.
Keywords
AZATHIOPRINE, INFLIXIMAB, SAFETY, INFECTIONS, inflammatory bowel disease, infliximab, adalimumab, thiopurines, anti-TNF antibodies, malignancy, pharmacoepidemiology, lymphoma, skin cancer, azathioprine, cancer, carcinoma, melanoma, tumor, NONMELANOMA SKIN CANCERS, T-CELL LYMPHOMA, CROHNS-DISEASE, RHEUMATOID-ARTHRITIS, INFLIXIMAB, AZATHIOPRINE, SAFETY, INDUCTION, THERAPY, INFECTIONS

Citation

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MLA
Beigel, F., et al. “Risk of Malignancies in Patients with Inflammatory Bowel Disease Treated with Thiopurines or Anti-TNF Alpha Antibodies.” PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, vol. 23, no. 7, WILEY-BLACKWELL, 2014, pp. 735–44, doi:10.1002/pds.3621.
APA
Beigel, F., Steinborn, A., Schnitzler, F., Tillack, C., Breiteneicher, S., John, J., … Ochsenkuhn, T. (2014). Risk of malignancies in patients with inflammatory bowel disease treated with thiopurines or anti-TNF alpha antibodies. PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, 23(7), 735–744. https://doi.org/10.1002/pds.3621
Chicago author-date
Beigel, F, A Steinborn, F Schnitzler, C Tillack, S Breiteneicher, JM John, Kristel Van Steen, et al. 2014. “Risk of Malignancies in Patients with Inflammatory Bowel Disease Treated with Thiopurines or Anti-TNF Alpha Antibodies.” PHARMACOEPIDEMIOLOGY AND DRUG SAFETY 23 (7): 735–44. https://doi.org/10.1002/pds.3621.
Chicago author-date (all authors)
Beigel, F, A Steinborn, F Schnitzler, C Tillack, S Breiteneicher, JM John, Kristel Van Steen, RP Laubender, B Goke, J Seiderer, S Brand, and T Ochsenkuhn. 2014. “Risk of Malignancies in Patients with Inflammatory Bowel Disease Treated with Thiopurines or Anti-TNF Alpha Antibodies.” PHARMACOEPIDEMIOLOGY AND DRUG SAFETY 23 (7): 735–744. doi:10.1002/pds.3621.
Vancouver
1.
Beigel F, Steinborn A, Schnitzler F, Tillack C, Breiteneicher S, John J, et al. Risk of malignancies in patients with inflammatory bowel disease treated with thiopurines or anti-TNF alpha antibodies. PHARMACOEPIDEMIOLOGY AND DRUG SAFETY. 2014;23(7):735–44.
IEEE
[1]
F. Beigel et al., “Risk of malignancies in patients with inflammatory bowel disease treated with thiopurines or anti-TNF alpha antibodies,” PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, vol. 23, no. 7, pp. 735–744, 2014.
@article{5906283,
  abstract     = {Purpose We aimed to analyse malignancy rates and predictors for the development of malignancies in a large German inflammatory bowel disease (IBD) cohort treated with thiopurines and/or anti-tumour necrosis factor (TNF) antibodies. Methods De novo malignancies in 666 thiopurine-treated and/or anti-TNF-treated IBD patients were analysed. Patients (n = 262) were treated with thiopurines alone and never exposed to anti-TNF antibodies (TP group). In addition, patients (n = 404) were exposed to anti-TNF antibodies (TNF+ group) with no (7.4%), discontinued (80.4%) or continued (12.1%) thiopurine therapy. Results In the TP group, 20 malignancies were observed in 18 patients compared with 8 malignancies in 7 patients in the TNF+ group (hazard ratio 4.15; 95% CI 1.82-9.44; p = 0.0007; univariate Cox regression). Moreover, 18.2% of all patients in the TP group >= 50 years of age developed a malignancy, compared with 3.8% of all patients <50 years of age (p = 0.0008). In the TNF+ group, 6.5% of all patients >= 50 years of age developed malignancies compared with 0.3% of all patients < 50 years of age (p = 0.0007). In both groups combined, thiopurine treatment duration >= 4 years was associated with the risk for skin cancer (p = 0.0024) and lymphoma (p = 0.0005). Conclusions Our data demonstrate an increased risk for the development of malignancies in IBD patients treated with thiopurines in comparison with patients treated with anti-TNF antibodies with or without thiopurines. Copyright (C) 2014 John Wiley & Sons, Ltd.},
  author       = {Beigel, F and Steinborn, A and Schnitzler, F and Tillack, C and Breiteneicher, S and John, JM and Van Steen, Kristel and Laubender, RP and Goke, B and Seiderer, J and Brand, S and Ochsenkuhn, T},
  issn         = {1053-8569},
  journal      = {PHARMACOEPIDEMIOLOGY AND DRUG SAFETY},
  keywords     = {AZATHIOPRINE,INFLIXIMAB,SAFETY,INFECTIONS,inflammatory bowel disease,infliximab,adalimumab,thiopurines,anti-TNF antibodies,malignancy,pharmacoepidemiology,lymphoma,skin cancer,azathioprine,cancer,carcinoma,melanoma,tumor,NONMELANOMA SKIN CANCERS,T-CELL LYMPHOMA,CROHNS-DISEASE,RHEUMATOID-ARTHRITIS,INFLIXIMAB,AZATHIOPRINE,SAFETY,INDUCTION,THERAPY,INFECTIONS},
  language     = {eng},
  number       = {7},
  pages        = {735--744},
  publisher    = {WILEY-BLACKWELL},
  title        = {Risk of malignancies in patients with inflammatory bowel disease treated with thiopurines or anti-TNF alpha antibodies},
  url          = {http://dx.doi.org/10.1002/pds.3621},
  volume       = {23},
  year         = {2014},
}

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