Survival in patients with rheumatoid arthritis and early breast cancer treated with tumor necrosis factor inhibitors.

Early breast cancer Rheumatoid arthritis Survival Tumor necrosis factor inhibitors

Journal

Breast cancer (Tokyo, Japan)
ISSN: 1880-4233
Titre abrégé: Breast Cancer
Pays: Japan
ID NLM: 100888201

Informations de publication

Date de publication:
08 Aug 2024
Historique:
received: 13 06 2024
accepted: 13 07 2024
medline: 9 8 2024
pubmed: 9 8 2024
entrez: 8 8 2024
Statut: aheadofprint

Résumé

There have been concerns about the use of tumor necrosis factor inhibitors (TNFi) for autoimmune disease in patients with recently diagnosed cancer. We assessed the survival of patients with rheumatoid arthritis (RA) and newly diagnosed early breast cancer (BC) treated with TNFi in the first two years after BC diagnosis. We identified patients in two datasets: (1) Optum's de-identified Clinformatics In the first year after BC, 165/970 (17.0%) and 201/1246 (16.1%) patients received TNFi in CDM and SEER/TCR-Medicare respectively. In the 1 year landmark, no significant differences in OS were observed between patients treated with TNFi and patients treated with csDMARDs only in CDM (hazard ratio [HR] = 0.77, 95% confidence interval [CI] 0.42-1.40) or SEER/TCR-Medicare (HR = 0.84, 95% CI 0.54-1.31). BCSS (SEER/TCR-Medicare) was better in patients receiving TNFi than in those receiving csDMARDs only (HR = 0.28, 95% CI 0.08-0.98). In CDM, glucocorticoid therapy had worse OS than those without glucocorticoids (HR = 2.18, 95% CI 1.13-4.18). This was also observed in SEER/TCR-Medicare (not statistically significant). Similar results were observed for the 2 year landmark. TNFi treatment during the first two years after early BC was not associated with worse survival.

Sections du résumé

BACKGROUND BACKGROUND
There have been concerns about the use of tumor necrosis factor inhibitors (TNFi) for autoimmune disease in patients with recently diagnosed cancer. We assessed the survival of patients with rheumatoid arthritis (RA) and newly diagnosed early breast cancer (BC) treated with TNFi in the first two years after BC diagnosis.
METHODS METHODS
We identified patients in two datasets: (1) Optum's de-identified Clinformatics
RESULTS RESULTS
In the first year after BC, 165/970 (17.0%) and 201/1246 (16.1%) patients received TNFi in CDM and SEER/TCR-Medicare respectively. In the 1 year landmark, no significant differences in OS were observed between patients treated with TNFi and patients treated with csDMARDs only in CDM (hazard ratio [HR] = 0.77, 95% confidence interval [CI] 0.42-1.40) or SEER/TCR-Medicare (HR = 0.84, 95% CI 0.54-1.31). BCSS (SEER/TCR-Medicare) was better in patients receiving TNFi than in those receiving csDMARDs only (HR = 0.28, 95% CI 0.08-0.98). In CDM, glucocorticoid therapy had worse OS than those without glucocorticoids (HR = 2.18, 95% CI 1.13-4.18). This was also observed in SEER/TCR-Medicare (not statistically significant). Similar results were observed for the 2 year landmark.
CONCLUSIONS CONCLUSIONS
TNFi treatment during the first two years after early BC was not associated with worse survival.

Identifiants

pubmed: 39117793
doi: 10.1007/s12282-024-01618-x
pii: 10.1007/s12282-024-01618-x
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : NIAMS NIH HHS
ID : R01AR078484
Pays : United States
Organisme : NIH/National Cancer Institute through MD Anderson's Cancer Center Support Grant
ID : P30CA016672
Organisme : Susan G. Komen
ID : SAC150061
Pays : United States

Informations de copyright

© 2024. The Author(s), under exclusive licence to The Japanese Breast Cancer Society.

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Auteurs

Juan I Ruiz (JI)

Department of Health Services Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1444, Houston, TX, 77030, USA.

Xiudong Lei (X)

Department of Health Services Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1444, Houston, TX, 77030, USA.

Wu Chi-Fang (W)

Department of Health Services Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1444, Houston, TX, 77030, USA.

Sharon H Giordano (SH)

Department of Health Services Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1444, Houston, TX, 77030, USA.

Hui Zhao (H)

Department of Health Services Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1444, Houston, TX, 77030, USA.

Suja S Rajan (SS)

Department of Management, Policy and Community Health, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA.

Heather Lin (H)

Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Maria E Suarez-Almazor (ME)

Department of Health Services Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1444, Houston, TX, 77030, USA. msalmazor@mdanderson.org.

Classifications MeSH