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Risk of malignancy in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis under immunosuppressive therapy: a single-center experience

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Abstract

Systemic inflammatory rheumatic diseases are associated with an increased risk of malignancy, in particular of lymphoproliferative disorders. Chronic inflammation, due to the disease itself, generates a microenvironment able to promote cancer development, but it is still controversial whether immunosuppressive therapy may contribute to carcinogenesis. The aim of the study was to evaluate the risk of malignancy in 399 patients affected by rheumatoid arthritis (RA), psoriatic arthritis and ankylosing spondylitis, all treated with either tumor necrosis factor α-inhibitors plus disease-modifying anti-rheumatic drugs (DMARDs) or DMARDs alone. The risk of malignancy in this cohort of patients, observed in the period between 2005 and 2011 at S. Andrea Hospital-Sapienza University of Rome, was compared with that of the general Italian population, matched for age, sex, and area of residence. Fourteen (3.5 %) malignancies, five of which were hematologic, have been observed. The overall cancer risk was not significantly increased in comparison to the general population, whereas the risk of hematologic malignancies appeared significantly higher in RA patients (SIR 4.94, 95 % CI 1.35–12.64), particularly in female gender (SIR 6.9, 0.95 % CI 1.88–17.66). No significant association between therapy and malignancy was demonstrated in RA patients.

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Authors declare that they have no conflict of interest.

Statement of human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the author.

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    Authors and Affiliations

    1. Unit of Allergy and Immuno-Rheumatology, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy

      Marta Fantò, Mario Pietrosanti, Roberta Di Rosa, Andrea Picchianti Diamanti, Simonetta Salemi & Raffaele D’Amelio

    2. Centre for Health and Veterinarian Research, Italian Army, Rome, Italy

      Mario Stefano Peragallo

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    1. Marta Fantò
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    2. Mario Stefano Peragallo
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    Correspondence to Marta Fantò.

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    M. Fantò and M. S. Peragallo equally contributed to the study.

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    Fantò, M., Peragallo, M.S., Pietrosanti, M. et al. Risk of malignancy in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis under immunosuppressive therapy: a single-center experience. Intern Emerg Med 11, 31–40 (2016). https://doi.org/10.1007/s11739-015-1270-0

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