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Risk of Hematologic Malignancies Is Increased in Patients With Psoriatic Arthritis
Hematologic malignancy incidence is not increased in patients with psoriatic arthritis (PsA) treated with tumor necrosis factor inhibitor (TNFi) compared with biologic disease-modifying anti-rheumatic drug (bDMARD)-naïve patients; however, the overall risk is increased in patients with PsA patients compared with the general population, according to a study published in RMD Open.
Researchers evaluated hematologic malignancy risk in patients with PsA overall and in relation to treatment with TNFi in a Nordic cohort study. The study identified 5 groups of patients with PsA from 2006 to 2019: patients starting a first TNFi identified from all Nordic countries in the clinical rheumatology registers (CRR), bDMARD-naïve patients from the CRR in all countries except Iceland, bDMARD-naïve patients from the national patient registers (NPR) in Denmark and Sweden, all patients from the CRR and NPR in Denmark and Sweden, and a general population comparator group from Denmark and Sweden. Patients with PsA had a 35% increased risk of hematologic malignancies compared with the general population.
In the TNFi-treated patients with PsA, 40 hematologic malignancies occurred, with a pooled incidence rate ratio (IRR) of 0.96 (0.68-1.35) versus biologics-naïve patients with PsA and 0.84 (0.64-1.10) versus biologics-naïve patients with PsA from the NPR. In PsA overall, the IRR of hematologic malignancies was 1.35 (1.17-1.55) versus the general population comparator group.
“To conclude, TNFi treatment did not increase the risk of [hematologic] malignancy overall, nor of lymphoid and myeloid types, in patients with PsA,” wrote the study authors. “However, there were signals of a moderately increased risk in patients with PsA overall as compared with the general population,” they added.
Reference
Cordtz RL, Askling J, Delcoigne B, et al. Haematological malignancies in patients with psoriatic arthritis overall and treated with TNF inhibitors: a Nordic cohort study. RMD Open. 2022;8(2):e002776. doi:10.1136/rmdopen-2022-002776
