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TNF Inhibitors Don't Increase Cancer Risk in Children

 

While the risk of neoplasia with tumour necrosis factor inhibitor (TNFi) use has been largely nullified in most inflammatory disorders, this risk in children is less certain. However a recent study shows no risk of increased cancer in children treated with TNFi for juvenile idiopathic arthritis (JIA), pediatric inflammatory bowel disease (pIBD) and pediatric plaque psoriasis (pPsO).

A retrospective US of administrative claims data from 2000 to 2014 compared 15,598 children on TNFi and 73,839 children not exposed to TNFi  who had JIA, pIBD or pPsO.

A totl of 15 malignancies were seen with TNFi use (SIR 2.9 ; 95%CI 1.6 to 4.9) compared with  42 without TNFi exposure (SIR 2.1; 1.5 to 2.9). The adjusted Hazard Ration  was 1.58 (0.88 to 2.85) for TNFi use versus no TNFi use.

Only in pIBD did the combined use of TNFi with a thiopurine result in a higher SIR (6.0 (1.2 to 17.5)) compared with TNFi use without thiopurine use (2.5 (0.7 to 6.4)).

 

Disclosures: 
The author has received compensation as an advisor or consultant on this subject

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