Table 2.
Association between exposure to TNFi and development of new solid cancer
| sDMARD | TNFi | |
|---|---|---|
| N=3249 | N=11 767 | |
| Ever-exposed to TNFi model | ||
| Total follow-up time (patient-years) | 11 672 | 52 549 |
| Follow-up per subject; median (IQR) | 4.1 (2.3, 5.0) | 5.0 (4.4, 5.0) |
| Cancers | 136 | 427 |
| Sources of reporting of solid cancers | ||
| Cancer registry (%) | 126 (93) | 399 (93) |
| Consultant/nurse (%) | 83 (61) | 322 (75) |
| Patient (%) | 23 (17) | 79 (19) |
| Incidence rate per 10 000 patient-years (95% CI) | 117 (98 to 138) | 81 (74 to 89) |
| Unadjusted HR (95% CI) | Referent | 0.70 (0.58 to 0.85) |
| Age and sex adjusted HR (95% CI) | Referent | 0.91 (0.75 to 1.11) |
| PD adjusted HR (95% CI) | Referent | 0.83 (0.64 to 1.07) |
| On TNFi (plus 90 days)* | ||
| Follow-up time (patient-years) | 10 275 | 39 173 |
| Cancers | 106 | 285 |
| PD adjusted HR (95% CI) | Referent | 0.81 (0.60 to 1.10) |
| Cumulative exposure to TNFi | ||
| <1.5 years | ||
| Follow-up time (patient-years) | 10 275 | 20 264 |
| No. solid cancers | 106 | 166 |
| PD adjusted HR (95% CI) | Referent | 0.87 (0.66 to 1.15) |
| 1.5 to <3 years | ||
| Follow-up time (patient-years) | 10 275 | 14 729 |
| No. solid cancers | 106 | 99 |
| PD adjusted HR (95% CI) | Referent | 0.85 (0.63 to 1.17) |
| PD adjusted HR (95% CI); <1.5 years referent | 0.91 (0.67 to 1.24) | |
| ≥3 years | ||
| Follow-up time (patient-years) | 10 275 | 13 969 |
| No. solid cancers | 106 | 100 |
| PD adjusted HR (95% CI) | Referent | 0.77 (0.58 to 1.03) |
| PD adjusted HR (95% CI); <1.5 years referent | 0.77 (0.58 to 1.02) | |
| All follow-up time (including first 6 months) | ||
| Follow-up time (patient-years) | 13 425 | 58 437 |
| Cancers | 166 | 449 |
| Incidence rate per 10 000 patient-years (95% CI) | 124 (106 to 144) | 77 (70 to 84) |
| PD adjusted HR (95% CI) | Referent | 0.77 (0.60 to 0.98) |
| Cancer registry reported cancers only | ||
| Follow-up time (patient-years) | 11 758 | 52 549 |
| Cancers | 126 | 399 |
| Incidence rate per 10 000 patient-years (95% CI) | 107 (89 to 128) | 76 (69 to 84) |
| PD adjusted HR (95% CI) | Referent | 0.86 (0.66 to 1.13) |
*Time after last received consultant follow-up form excluded from these analyses.
PD, propensity score stratified into deciles; sDMARD, synthetic disease modifying antirheumatic drug; TNFi, tumour necrosis factor inhibitor.