Hazard ratios highest for patients exposed to immunomodulators and biologics or second-line biologics
By Elana Gotkine HealthDay Reporter
WEDNESDAY, May 10, 2023 (HealthDay News) — Crohn disease (CD) and ulcerative colitis (UC) are associated with a slightly increased risk for lymphoma, according to a study published online April 13 in Clinical Gastroenterology and Hepatology.
Ola Olén M.D., from the Karolinska Institutet in Stockholm, and colleagues compared lymphoma risk in 164,716 patients with inflammatory bowel disease and 1,639,027 matched general population reference individuals in a binational register-based cohort study (Sweden and Denmark) during 1969 to 2019.
The researchers found that 258 patients with CD, 479 with UC, and 6,675 matched reference individuals developed lymphoma during 1969 to 2019, corresponding to incidence rates of 35 and 34 per 100,000 person-years among people with CD and UC, respectively, compared with 28 and 33 per 100,000 person-years, respectively, in their matched reference individuals. Both CD and UC were associated with an increase in lymphoma (hazard ratios, 1.32 and 1.09, respectively), but the 10-year cumulative incidence difference was low (0.08 percent in CD). The past two decades saw an increase in hazard ratios, corresponding to increasing use of immunomodulators and biologics. In CD and UC patients, hazard ratios were increased for aggressive B-cell non-Hodgkin lymphoma; CD patients had an increase in T-cell non-Hodgkin lymphoma. Patients exposed to combination therapy or second-line biologics had the highest hazard ratios, but those who were not on such drugs also had increased hazard ratios.
“Given the very low excess risk of lymphoma in our study, and the previous finding that few lymphomas are located in the gastrointestinal tract, we see no reason for considering surveillance or screening for lymphoma in inflammatory bowel disease,” the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.
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