Evidence map›Paper›PMID 21885875›Full record

SynthesisAnnals of the rheumatic diseases2011

Malignancies associated with tumour necrosis factor inhibitors in registries and prospective observational studies: a systematic review and meta-analysis.

Xavier Mariette, Marco Matucci-Cerinic, Karel Pavelka, Peter Taylor, Ronald van Vollenhoven, Rebecca Heatley, Claire Walsh, Richard Lawson, Alan Reynolds, Paul Emery

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Annals of the rheumatic diseases, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 148 papers, 18 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
148citing papers in PubMed, 18 pooled it
24.3field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

148 citing papers in PubMed, 18 syntheses or guidelines pooled it, 404 citations in OpenAlex.

  1. Tumor necrosis factor (TNF) inhibitors for psoriatic arthritis.The Cochrane database of systematic reviews · 2025
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  10. ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease.The American journal of gastroenterology · 2017
    Guideline
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  15. Potential increased risk of cancer from commonly used medications: an umbrella review of meta-analyses.Annals of oncology : official journal of the European Society for Medical Oncology · 2014
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  20. Long-term safety of vedolizumab for inflammatory bowel disease.Alimentary pharmacology & therapeutics · 2020
    Trial

88 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 5 countries.

Xavier MarietteHôpital Bicêtre, Institut Pour la Santé et Recherche Médicale (INSERM) U 1012, Université Paris-Sud 11, Le Kremlin Bicêtre, France. xavier.mariette@bct.aphp.fr
Marco Matucci-Cerinic
Karel Pavelka
Peter Taylor
Ronald van Vollenhoven
Rebecca Heatley
Claire Walsh
Richard Lawson
Alan Reynolds
Paul Emery
East Cheshire NHS Trust · GBCharles University · CZInserm · FRKarolinska Institutet · SEUniversity of Florence · ITUniversity of Leeds · GB

Funding

Versus Arthritis 18475
6 · The paper itself

Abstract

objectivesThis project was undertaken to assess the risk of malignancy in patients with rheumatoid arthritis treated with tumour necrosis factor inhibitors (TNFi) in clinical practice, as recorded in prospective, observational studies.

methodsThe authors undertook comprehensive searches of MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews and American College of Rheumatology, European League against Rheumatism and British Society for Rheumatology conference abstracts according to a prespecified protocol.

resultsThe searches identified 2039 full-text papers and 1979 conference abstracts, of which 21 full texts and eight abstracts met the inclusion criteria. The pooled estimate for the risk of all-site malignancy from seven studies was 0.95 (95% CI 0.85 to 1.05). Two studies reported there was no evidence that longer exposure to TNFi agents increased the risk of malignancy. In patients with previous malignancies there was a higher risk of a new/recurring malignancy. This risk was not increased further by exposure to TNFi, although CI were wide. Results from four studies showed that patients treated with TNFi have a significantly increased risk of developing a non-melanoma skin cancer (1.45, 95% CI 1.15 to 1.76). In addition, patients are at an increased risk of developing melanoma, as the pooled estimate from two studies was 1.79 (95% CI 0.92 to 2.67). The pooled estimate for the risk of lymphoma was 1.11 (95% CI 0.70 to 1.51).

conclusionsThis systematic review and meta-analysis shows that TNFi treatments do not increase the risk of malignancy, particularly lymphoma. However, they do appear to increase the risk of skin cancer, including melanoma.

Indexed as

Antirheumatic AgentsArthritisEpidemiologic MethodsHumansImmunosuppressive AgentsLymphomaNeoplasmsRegistriesSkin NeoplasmsTumor Necrosis Factor-alphaAntirheumatic AgentsImmunosuppressive AgentsTumor Necrosis Factor-alpha

Identifiers

PMID21885875
OpenAlexW2166305732

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.