Infliximab and newly diagnosed neoplasia in Crohn's disease: a multicentre matched pair study

Biancone, L.; Orlando, A.; Kohn, A.; Colombo, E.; Sostegni, R.; Angelucci, E.; Rizzello, F.; Castiglione, F.; Benazzato, I.; Papi, C.; Meucci, G.; Riegler, G.; Petruzziello, C.; Mocciaro, F.; Geremia, A.; Calabrese, E.; Cottone, M.; Pallone, F.
February 2006
Gut;Feb2006, Vol. 55 Issue 2, p228
Academic Journal
Background and aims: The widespread use of anti-tumour necrosis factor α antibody (Infliximab) in Crohn's disease (CD) raises concerns about a possible cancer risk in the long term. In a matched pair study, we assessed whether Infliximab is associated with an increased risk of neoplasia. Methods: In a multicentre matched pair study, 404 CD patients treated with Infliximab (CD-IFX) were matched with 404 CD patients who had never received Infliximab (CD-C). Cases and controls were matched for sex, age (± 5 years), site of CD, age at diagnosis (± 5 years), immunosuppressant use, and follow up. New diagnoses of neoplasia from April 1999 to October 2004 were recorded. Results: Among the 404 CD-IFX, neoplasia was diagnosed in nine patients (2.22%) while among the 404 CD-C, seven patients developed neoplasia (1.73%) (odds ratio 1.33 (95% confidence interval 0.46–3.84); p = 0.40). The survival curve adjusted far patient year of fallow up showed no differences between CD-IFX and CD-C (p=0.90; log rank test). In the CD-IFX group, there was one cholangiocarcinoma, three breast cancers, one skin cancer, one leukaemia, one laryngeal cancer, and two anal carcinomas. Among the 7/404 (1.73%) CD-C, there were three intestinal adenocarcinomas (two caecum, one rectum), one basalioma, one spinalioma, one non-Hodgkin's lymphoma, and one breast cancer. Age at diagnosis of neaplasla did not differ between groups (CD-IFX v CD-C: median 50 (range 40–70 years) v 45 [27–72); p=0.50). Conclusion: In our multicentre matched pair study, the frequency of a new diagnosis of neoplasia in CD patients treated with Infliximab was comparable with CD patients who had never received Infliximab.


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