Rheumatoid Arthritis and Risk of Malignant Lymphoma - Is the risk still increased?

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Fältnamn	Indikatorer	Metadata
000		03990naa a2200445 4500
001		oai:DiVA.org:uu-318580
003		SwePub
008		170326s2017 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
009		oai:prod.swepub.kib.ki.se:135388158
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3185802 URI
024	7	a https://doi.org/10.1002/art.400172 DOI
024	7	a http://kipublications.ki.se/Default.aspx?queryparsed=id:1353881582 URI
040		a (SwePub)uud (SwePub)ki
041		a engb eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Hellgren, K.u Karolinska Institutet4 aut
245	1 0	a Rheumatoid Arthritis and Risk of Malignant Lymphoma - Is the risk still increased?
264		c 2017-03-29
264	1	b Wiley,c 2017
338		a print2 rdacarrier
520		a OBJECTIVE: Patients with rheumatoid arthritis (RA) are at increased risk of malignant lymphomas with a strong correlation with RA disease severity. Given the changes in RA therapy over recent decades, we aimed at assessing whether lymphoma risk remains increased, and if so, to explore risk predictors and lymphoma subtypes.METHODS: We identified 12,656 incident RA patients from the Swedish Rheumatology Register 1997-2012 including information on therapy and inflammatory activity during the first year following diagnosis. Each patient was matched to 10 population comparator subjects. Through linkage to the Swedish Cancer Register, lymphomas including subtypes were identified. We assessed Hazard ratios (HRs) using Cox regression.RESULTS: Overall, the HR of lymphoma was increased, 1.6, 95% confidence interval [CI] 1.2-2.1. Taking RA duration into account, risks did not appear to have declined over successive calendar years of RA diagnosis. Neither use of methotrexate the 1(st) year following RA diagnosis nor ever use of TNF inhibitors (HR=0.9; 95% CI 0.4-1.9) increased lymphoma risk. Use of oral corticosteroids the 1(st) year following RA diagnosis was associated with a reduced risk (HR=0.6; 95% CI 0.5 -0.9). Inflammatory activity during the 1(st) year following RA diagnosis did not predict future lymphoma risk. Chronic lymphocytic lymphoma occurred less, and Hodgkin lymphoma more frequently than expected compared to the general population.CONCLUSION: The average lymphoma risk in recently diagnosed RA is of similar magnitude as that reported from historical cohorts. Standard anti-rheumatic treatment including TNF inhibitors did not predict future lymphoma risk. Distribution of lymphoma subtypes warrants further investigation.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Reumatologi och inflammation0 (SwePub)302102 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Rheumatology and Autoimmunity0 (SwePub)302102 hsv//eng
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Klinisk laboratoriemedicin0 (SwePub)302232 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Clinical Laboratory Medicine0 (SwePub)302232 hsv//eng
653		a Patologi
653		a Pathology
700	1	a Baecklund, Eva,d 1956-u Uppsala universitet,Reumatologi4 aut0 (Swepub:uu)evaba786
700	1	a Backlin, Carinu Uppsala universitet,Reumatologi4 aut0 (Swepub:uu)kariback
700	1	a Sundström, Christeru Uppsala universitet,Klinisk och experimentell patologi,Rose-Marie Amini4 aut0 (Swepub:uu)chrisund
700	1	a Smedby, K. E.u Karolinska Institutet4 aut
700	1	a Askling, J.u Karolinska Institutet4 aut
710	2	a Karolinska Institutetb Reumatologi4 org
773	0	t Arthritis & Rheumatologyd : Wileyg 69:4, s. 700-708q 69:4<700-708x 2326-5191x 2326-5205
856	4	u https://www.onlinelibrary.wiley.com/doi/pdfdirect/10.1002/art.40017
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-318580
856	4 8	u https://doi.org/10.1002/art.40017
856	4 8	u http://kipublications.ki.se/Default.aspx?queryparsed=id:135388158

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Av författaren/redakt...: Hellgren, K.; Baecklund, Eva, ...; Backlin, Carin; Sundström, Chris ...; Smedby, K. E.; Askling, J.

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Reumatologi och ...

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