ArticleAmerican journal of ophthalmology2008
Long-term risk of malignancy among patients treated with immunosuppressive agents for ocular inflammation: a critical assessment of the evidence.
Article in American journal of ophthalmology, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
50 citing papers in PubMed, 3 syntheses or guidelines pooled it, 135 citations in OpenAlex.
- Pooled it
- [DOG and BVA guideline no. 24b : Noninfectious uveitis posterior].Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft · 2017Guideline
- Evidence-based, interdisciplinary guidelines for anti-inflammatory treatment of uveitis associated with juvenile idiopathic arthritis.Rheumatology international · 2012Guideline
- Trial
- Treatment of inflammatory macular edema with humanized anti-CD11a antibody therapy.Investigative ophthalmology & visual science · 2011Trial
- Formulation of Polymeric Nanoparticles Loading Baricitinib as a Topical Approach in Ocular Application.Pharmaceutics · 2024Article
- Use of Immunosuppression and the Risk of Subsequent Overall or Cancer Mortality.Ophthalmology · 2023Article
- Synthetically glycosylated antigens for the antigen-specific suppression of established immune responses.Nature biomedical engineering · 2023Article
- Use of immunosuppression and subsequent cancer incidence: cohort study.BMJ oncology · 2023Article
- The Conundrum of Clinical Trials for the Uveitides: Appropriate Outcome Measures for One Treatment Used in Several Diseases.Epidemiologic reviews · 2022Article
- Current Landscape of Uveitis Specialists in the United States.Journal of academic ophthalmology (2017) · 2022Article
- Classification Criteria for Serpiginous Choroiditis.American journal of ophthalmology · 2021Article
- Cancer risks along the disease trajectory in antineutrophil cytoplasmic antibody associated vasculitis.Clinical rheumatology · 2020Review
- Ocular side effects of antirheumatic medications: a qualitative review.BMJ open ophthalmology · 2020Review
- Uveitis Therapy With Shark Variable Novel Antigen Receptor Domains Targeting Tumor Necrosis Factor Alpha or Inducible T-Cell Costimulatory Ligand.Translational vision science & technology · 2019Article
- Ocular mucous membrane pemphigoid: a review.Immunologic research · 2019Review
- Relapse of Juvenile Idiopathic Arthritis-Associated Uveitis after Discontinuation of Immunomodulatory Therapy.Ocular immunology and inflammation · 2019Article
- Efficacy and adverse reactions of methotrexate in the treatment of ocular cicatricial pemphigoid: A case series study.Medicine · 2018Observational
- Immunosuppression for the Uveitides.Ophthalmology · 2018Review
- Biological therapies for the treatment of Behçet's disease-related uveitis beyond TNF-alpha blockade: a narrative review.Rheumatology international · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 6 institutions in 1 country.
Funding
Abstract
purposeTo critically assess potentially carcinogenic effects of immunosuppressive therapy in the ocular inflammation setting.
designFocused evidence assessment.
methodsRelevant publications were identified by MEDLINE and EMBASE queries and reference list searches.
resultsExtrapolation from transplant, rheumatology, skin disease, and inflammatory bowel disease cohorts to the ocular inflammation setting suggest that: 1) alkylating agents increase hematologic malignancy risk and cyclophosphamide increases bladder cancer risk, but less so with < or =18 months' duration of therapy and hydration, respectively; 2) calcineurin inhibitors and azathioprine probably do not increase total cancer risk to a detectable degree, except perhaps some other risk factors (uncommon in ocular inflammation patients) might interact with the former to raise risk; 3) tumor necrosis factor (TNF) inhibitors may accelerate diagnosis of cancer in the first six to 12 months, but probably do not increase long-term cancer risk; and 4) changes in risk with methotrexate, mycophenolate mofetil, and daclizumab appear negligible, although nontransplant data are limited for the latter agents. Immunosuppression in general may increase skin cancer risk in a sun exposure-dependent manner.
conclusionUse of alkylating agents for a limited duration seems justifiable for severe, vision-threatening disease, but otherwise cancer risk may be a relevant constraint on use of this approach. Antimetabolites, daclizumab, TNF inhibitors, and calcineurin inhibitors probably do not increase cancer risk to a degree that outweighs the expected benefits of therapy. Monitoring for skin cancer may be useful for highly sun-exposed patients. Data from ocular inflammation patients are needed to confirm the conclusions made in this analysis by extrapolation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.