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Most Immunosuppressive Drugs Not Linked to Risk for Cancer

No associations seen for TNF inhibitor, antimetabolite, calcineurin inhibitor, or alkylating agent classes with cancer

By Elana Gotkine HealthDay Reporter

MONDAY, Aug. 28, 2023 (HealthDay News) — For patients with ocular inflammatory disease (OID), short-term therapy with commonly used immunosuppressive drug classes and many drugs is not associated with an increased risk for cancer incidence, according to a study published online Aug. 21 in BMJ Oncology.

Jeanine M. Buchanich, Ph.D., from the University of Pittsburgh School of Public Health, and colleagues conducted a retrospective cohort study involving patients from 10 U.S. OID subspecialty practices. Time-dependent exposure to drug classes and drugs was evaluated. By linkage to 12 state cancer registries, cancer incidence was ascertained.

The cancer incidence cohort included 10,872 individuals at risk for incident cancer and residing in one of the 12 states covered. With median follow-up of 10 years, the researchers identified 812 primary cancers. After adjustment for covariates, there were no associations for tumor necrosis factor inhibitor, antimetabolite, calcineurin inhibitor, or alkylating agent classes with significant increases in cancer. In the systemic inflammatory disease (SID)-including cohort, significantly reduced hazards were seen for adalimumab and chlorambucil, while increased hazards were seen for tacrolimus and etanercept in the non-SID cohort; in both, reduced hazards were seen for methotrexate. No association with overall cancer incidence was seen for other immunosuppressive drugs.

“Immunosuppressants are widely used and transformative for care of patients with inflammatory diseases, but the potential concern that they carry a cancer risk has forced people to make difficult decisions without enough information. Alleviating that concern with use for inflammatory diseases will help people make the treatment decision that’s right for them,” Buchanich said in a statement.

Several authors disclosed ties to the biopharmaceutical industry.

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