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Our objective was to determine the risk of NHL associated with TNFI use by duration and type of anti\u2010TNF agent. We performed a nested case\u2010control study within a retrospective cohort of adults with rheumatologic conditions from a U.S. commercial health insurance database between 2009 and 2015. Use of TNFIs (infliximab, adalimumab, etanercept, golimumab and certolizumab pegol) and conventional\u2010synthetic disease\u2010modifying antirheumatic drugs (csDMARDs) was identified, and conditional logistic regression models were used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI) for risk of NHL. From a retrospective cohort of 55,446 adult patients, 101 NHL cases and 984 controls matched on age, gender and rheumatologic indication were included. Compared to controls, NHL cases had greater TNFI use (33%<jats:italic>vs<\/jats:italic>. 20%) but were similar in csDMARD use (70%<jats:italic>vs<\/jats:italic>. 71%). TNFI ever\u2010use was associated with nearly two\u2010fold increased risk of NHL (OR\u00a0=\u00a01.93; 95% CI: 1.16\u20133.20) with suggestion of increasing risk with duration (P\u2010trend\u00a0=\u00a00.05). TNF fusion protein (etanercept) was associated with increased NHL risk (OR\u00a0=\u00a02.73; 95% CI: 1.40\u20135.33), whereas risk with anti\u2010TNF monoclonal antibodies was not statistically significant (OR\u00a0=\u00a01.77; 95% CI: 0.87\u20133.58). In sensitivity analyses evaluating confounding by rheumatologic disease severity, channeling bias was not likely to account for our results. Our findings support the FDA black box warning for NHL. Continued surveillance and awareness of this rare but serious adverse outcome are warranted with new TNFIs and biosimilar products forthcoming.<\/jats:p>","DOI":"10.1002\/ijc.31407","type":"journal-article","created":{"date-parts":[[2018,3,31]],"date-time":"2018-03-31T05:45:21Z","timestamp":1522475121000},"page":"1062-1071","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":55,"title":["Tumor necrosis factor\u2010alpha inhibitors and risk of non\u2010Hodgkin lymphoma in a cohort of adults with rheumatologic conditions"],"prefix":"10.1002","volume":"143","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7744-3518","authenticated-orcid":false,"given":"Gregory S.","family":"Calip","sequence":"first","affiliation":[{"name":"Department of Pharmacy Systems, Outcomes and Policy University of Illinois at Chicago Chicago IL"},{"name":"University of Illinois at Chicago, Center for Pharmacoepidemiology and Pharmacoeconomic Research Chicago IL"},{"name":"Division of Public Health Sciences, Epidemiology Program Fred Hutchinson Cancer Research Center Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pritesh R.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology Oncology University of Illinois at Chicago Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sruthi","family":"Adimadhyam","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Systems, Outcomes and Policy University of Illinois at Chicago Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Xing","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Systems, Outcomes and Policy University of Illinois at Chicago Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoju","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Systems, Outcomes and Policy University of Illinois at Chicago Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Sweiss","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice University of Illinois at Chicago Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glen T.","family":"Schumock","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Systems, Outcomes and Policy University of Illinois at Chicago Chicago IL"},{"name":"University of Illinois at Chicago, Center for Pharmacoepidemiology and Pharmacoeconomic Research Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd A.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Systems, Outcomes and Policy University of Illinois at Chicago Chicago IL"},{"name":"University of Illinois at Chicago, Center for Pharmacoepidemiology and Pharmacoeconomic Research Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian C.\u2010H.","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences The University of Chicago Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,4,16]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kes114"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.30653"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745-7254.2008.00889.x"},{"key":"e_1_2_6_5_1","unstructured":"U.S. Food and Drug Administration. 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