Risk of hematologic malignancies in psoriasis and rheumatoid arthritis patients using long term TNF-α inhibitors: a retrospective nationwide study

Abstract This retrospective cohort study included all user of tumor necrosis factor-α inhibitors (TNFi), including etanercept, infliximab, adalimumab, and golimumab, among Korean patients with psoriasis and rheumatoid arthritis (N of user = 7,645) and the non-user who was diagnosed with same disease...

Full description

Saved in:
Bibliographic Details
Main Authors: Jihun Song, Seong Rae Kim, Yu-Jin Kim, Sun Jae Park, Seogsong Jeong, Sang Min Park
Format: Article
Language:English
Published: Nature Portfolio 2025-03-01
Series:Scientific Reports
Subjects:
Online Access:https://doi.org/10.1038/s41598-025-90996-z
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850029755787640832
author Jihun Song
Seong Rae Kim
Yu-Jin Kim
Sun Jae Park
Seogsong Jeong
Sang Min Park
author_facet Jihun Song
Seong Rae Kim
Yu-Jin Kim
Sun Jae Park
Seogsong Jeong
Sang Min Park
author_sort Jihun Song
collection DOAJ
description Abstract This retrospective cohort study included all user of tumor necrosis factor-α inhibitors (TNFi), including etanercept, infliximab, adalimumab, and golimumab, among Korean patients with psoriasis and rheumatoid arthritis (N of user = 7,645) and the non-user who was diagnosed with same diseases, never used TNFi, and was served as the reference. Cumulative usage of TNFi was calculated between the newly diagnosed date and index date (2-year from the diagnosed date). Adjusted hazard ratio (aHR [95% confidence intervals (CIs)]) for colorectal, liver, lung, kidney, breast, and thyroid cancer were not significantly increased or decreased: 0.92 [0.61–1.38], 0.90 [0.53–1.53], 1.00 [0.73–1.37], 1.20 [0.62–2.34], 0.91 [0.62–1.34], and 0.91 [0.66–1.26], respectively. The increased risk of lymphoma in the infliximab user (2.49 [1.33–4.66]; p < 0.01) was statistically significant. Similarly, the risk of leukemia increased significantly in the etanercept (3.87 [1.71–8.76]; p < 0.01) and adalimumab (3.36 [1.65, 6.84]; p < 0.001) user. Accumulated prescriptions of TNFi for two years did not increase the incidence of cancer, except lymphoma and leukemia. Since the use of TNFi increases the risk of leukemia and lymphoma, a decision for frequent prescription of TNF-α inhibitors should be more careful.
format Article
id doaj-art-6a14496dfd6c4bd1835fefaa3e3dfa58
institution DOAJ
issn 2045-2322
language English
publishDate 2025-03-01
publisher Nature Portfolio
record_format Article
series Scientific Reports
spelling doaj-art-6a14496dfd6c4bd1835fefaa3e3dfa582025-08-20T02:59:24ZengNature PortfolioScientific Reports2045-23222025-03-011511810.1038/s41598-025-90996-zRisk of hematologic malignancies in psoriasis and rheumatoid arthritis patients using long term TNF-α inhibitors: a retrospective nationwide studyJihun Song0Seong Rae Kim1Yu-Jin Kim2Sun Jae Park3Seogsong Jeong4Sang Min Park5Department of Biomedical Sciences, Seoul National University Graduate SchoolDepartment of Dermatology, Seoul National University College of MedicineCenter for Biomaterials, Biomedical Research Institute, Korea Institute of Science and TechnologyDepartment of Biomedical Sciences, Seoul National University Graduate SchoolDepartment of Biomedical Informatics, Korea University College of MedicineDepartment of Biomedical Sciences, Seoul National University Graduate SchoolAbstract This retrospective cohort study included all user of tumor necrosis factor-α inhibitors (TNFi), including etanercept, infliximab, adalimumab, and golimumab, among Korean patients with psoriasis and rheumatoid arthritis (N of user = 7,645) and the non-user who was diagnosed with same diseases, never used TNFi, and was served as the reference. Cumulative usage of TNFi was calculated between the newly diagnosed date and index date (2-year from the diagnosed date). Adjusted hazard ratio (aHR [95% confidence intervals (CIs)]) for colorectal, liver, lung, kidney, breast, and thyroid cancer were not significantly increased or decreased: 0.92 [0.61–1.38], 0.90 [0.53–1.53], 1.00 [0.73–1.37], 1.20 [0.62–2.34], 0.91 [0.62–1.34], and 0.91 [0.66–1.26], respectively. The increased risk of lymphoma in the infliximab user (2.49 [1.33–4.66]; p < 0.01) was statistically significant. Similarly, the risk of leukemia increased significantly in the etanercept (3.87 [1.71–8.76]; p < 0.01) and adalimumab (3.36 [1.65, 6.84]; p < 0.001) user. Accumulated prescriptions of TNFi for two years did not increase the incidence of cancer, except lymphoma and leukemia. Since the use of TNFi increases the risk of leukemia and lymphoma, a decision for frequent prescription of TNF-α inhibitors should be more careful.https://doi.org/10.1038/s41598-025-90996-zCohort studyTNF-alphaCancerLeukemiaLymphoma
spellingShingle Jihun Song
Seong Rae Kim
Yu-Jin Kim
Sun Jae Park
Seogsong Jeong
Sang Min Park
Risk of hematologic malignancies in psoriasis and rheumatoid arthritis patients using long term TNF-α inhibitors: a retrospective nationwide study
Scientific Reports
Cohort study
TNF-alpha
Cancer
Leukemia
Lymphoma
title Risk of hematologic malignancies in psoriasis and rheumatoid arthritis patients using long term TNF-α inhibitors: a retrospective nationwide study
title_full Risk of hematologic malignancies in psoriasis and rheumatoid arthritis patients using long term TNF-α inhibitors: a retrospective nationwide study
title_fullStr Risk of hematologic malignancies in psoriasis and rheumatoid arthritis patients using long term TNF-α inhibitors: a retrospective nationwide study
title_full_unstemmed Risk of hematologic malignancies in psoriasis and rheumatoid arthritis patients using long term TNF-α inhibitors: a retrospective nationwide study
title_short Risk of hematologic malignancies in psoriasis and rheumatoid arthritis patients using long term TNF-α inhibitors: a retrospective nationwide study
title_sort risk of hematologic malignancies in psoriasis and rheumatoid arthritis patients using long term tnf α inhibitors a retrospective nationwide study
topic Cohort study
TNF-alpha
Cancer
Leukemia
Lymphoma
url https://doi.org/10.1038/s41598-025-90996-z
work_keys_str_mv AT jihunsong riskofhematologicmalignanciesinpsoriasisandrheumatoidarthritispatientsusinglongtermtnfainhibitorsaretrospectivenationwidestudy
AT seongraekim riskofhematologicmalignanciesinpsoriasisandrheumatoidarthritispatientsusinglongtermtnfainhibitorsaretrospectivenationwidestudy
AT yujinkim riskofhematologicmalignanciesinpsoriasisandrheumatoidarthritispatientsusinglongtermtnfainhibitorsaretrospectivenationwidestudy
AT sunjaepark riskofhematologicmalignanciesinpsoriasisandrheumatoidarthritispatientsusinglongtermtnfainhibitorsaretrospectivenationwidestudy
AT seogsongjeong riskofhematologicmalignanciesinpsoriasisandrheumatoidarthritispatientsusinglongtermtnfainhibitorsaretrospectivenationwidestudy
AT sangminpark riskofhematologicmalignanciesinpsoriasisandrheumatoidarthritispatientsusinglongtermtnfainhibitorsaretrospectivenationwidestudy