Comparing the lifetime risks of TNF-alpha inhibitor use to common benchmarks of risk

作者：Kaminska Edi; Patel Isha^*; Dabade Tushar S; Chang Jongwha; Qureshi Ayub A; O'Neill Jenna L; Balkrishnan Rajesh; Feldman Steven R

来源：Journal of Dermatological Treatment, 2013, 24(2): 101-106.

DOI：10.3109/09546634.2011.595574

• tumor necrosis factor inhibitor
• tuberculosis
• lymphoma
• demyelinating disease
• lifetime risk

Objective: The study aims to illustrate the range of lifetime risks of lymphoma, tuberculosis (TB), and demyelinating diseases with TNF-alpha inhibitors in psoriasis patients. Methods: Previously published data and online resources were used to determine the risk of the TB, demyelinating disease, and lymphoma with and without TNF-alpha inhibitor treatment. Lifetime risks for heart disease and stroke were collected using a Medline search. All cancer, trauma, and environmental statistics were obtained from the data published by National Cancer Institute, National Safety Council, and the National Oceanic and Atmospheric Administration, respectively. Results: The lifetime risks of TNF-alpha-inhibitor-linked conditions and comparators are as follows: TNF-alpha inhibitor-linked conditions: lymphoma with: without TNF-alpha inhibitors (0.5-4.8%: 2.3%), TB with: without TNF-alpha inhibitors (0-17.1%: 0.3%), and demyelinating disease with: without TNF-alpha inhibitors (0.1-1.7%: 0.15%). Comparators: cancer (40.4%), heart disease (36.2%), stroke (18.4%), accidental death (3.0%), motor vehicle death (1.2%), and lightning strike (0.033%). Limitations: Much of the data on lifetime risks of disease with TNF-alpha inhibitor were for patients with rheumatoid arthritis and not psoriasis. Conclusions: The risks of lymphoma, demyelinating diseases, and tuberculosis with TNF-alpha inhibitors are lower than risks patients face on a regular basis. Screening reduces the risk of tuberculosis in patients receiving TNF-alpha inhibitors.

• 出版日期2013-4