{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T10:50:16Z","timestamp":1782125416655,"version":"3.54.5"},"reference-count":54,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100010793","name":"Pfizer Japan","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010793","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The study aimed to evaluate the incidence rate and potential risk factors of malignancies in Japanese patients with rheumatoid arthritis (RA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective observational study analyzed data of adult patients with RA from April 2013 to March 2019 using the NinJa database. Patients were categorized into the overall RA cohort and sub\u2010cohorts: biologic disease\u2010modifying antirheumatic drug (bDMARDs) or Janus kinase inhibitors (JAKi\u2010s)\u2010exposed, bDMARDs exposed, and bDMARDs or JAKi\u2010s na\u00efve conventional synthetic DMARDs exposed. The incidence of overall and each type of malignancy was calculated, and the associated risk factors were analyzed using multivariate logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 26\u2009607 patients were included in the overall RA cohort (mean age: 64.16\u2009\u00b1\u200913.29\u2009years; female: 78.87%) with 1018 malignancies. The incidence of malignancies was similar to that in the general population, with a standardized incidence ratio (SIR) of 0.97 (95% confidence interval [CI]: 0.91\u20131.03). It was consistent across the sub\u2010cohorts and each year. The most frequent malignancies were lung cancer (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009158), lymphoma (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009151) and colorectal cancer (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009145). The incidence of lymphoma and skin cancer was higher than the general population, with SIRs of 4.00 (3.39\u20134.68) and 1.70 (1.25\u20132.30), respectively. Multivariate analysis showed older age, male sex, smoking, Steinbrocker stage score 2 versus 1, 4 versus 1, and higher Disease Activity Score 28 using C\u2010reactive protein as potential risk factors for malignancies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Japanese patients with RA did not have an elevated risk of overall malignancies, whereas the incidence of lymphoma and skin cancer was higher in patients with RA than in the general population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1756-185x.70363","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T23:08:52Z","timestamp":1752620932000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Incidence and Risk of Malignancy in Japanese Patients With Rheumatoid Arthritis in the National Database of Rheumatic Diseases in Japan (\n                    <scp>NinJa<\/scp>\n                    Database)"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7686-3211","authenticated-orcid":false,"given":"Toshihiro","family":"Matsui","sequence":"first","affiliation":[{"name":"Department of Rheumatology Research, Clinical Research Center for Allergy and Rheumatology National Hospital Organization Sagamihara National Hospital  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aosa","family":"Kamezaki\u2010Nakagawa","sequence":"additional","affiliation":[{"name":"RWE Platform, Chief Medical Affairs Office Pfizer Inc.  New York New York USA"},{"name":"Medical Affairs Pfizer Japan Inc.  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Hoshi","sequence":"additional","affiliation":[{"name":"Medical Affairs Pfizer Japan Inc.  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Hirano","sequence":"additional","affiliation":[{"name":"Medical Affairs Pfizer Japan Inc.  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naonobu","family":"Sugiyama","sequence":"additional","affiliation":[{"name":"Medical Affairs Pfizer Japan Inc.  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshitaka","family":"Hirano","sequence":"additional","affiliation":[{"name":"Medical Affairs Pfizer Japan Inc.  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miwa","family":"Enami","sequence":"additional","affiliation":[{"name":"Medical Affairs Pfizer Japan Inc.  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeyuki","family":"Toyoizumi","sequence":"additional","affiliation":[{"name":"Pfizer R&amp;D Japan G.K  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fujio","family":"Matsuyama","sequence":"additional","affiliation":[{"name":"CRECON Medical Assessment Inc.  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsunori","family":"Murata","sequence":"additional","affiliation":[{"name":"CRECON Medical Assessment Inc.  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5424-2203","authenticated-orcid":false,"given":"Yukitomo","family":"Urata","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Tsugaru General Hospital United Municipalities of Tsugaru  Aomori Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimito","family":"Kawahata","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Allergology St. Marianna University School of Medicine  Kawasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeto","family":"Tohma","sequence":"additional","affiliation":[{"name":"Department of Rheumatology National Hospital Organization Tokyo National Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,15]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.200367"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/14397595.2013.854059"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891\u2010021\u201004259\u20109"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756\u2010185X.13974"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.140533"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10030509"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.30134"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296\u2010010\u20101524\u20100"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar2404"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075\u2010015\u20100728\u20109"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296\u2010014\u20102982\u20106"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.3904\/kjim.2021.146"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40744\u2010024\u201000689\u20108"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.2147\/OARRR.S282627"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15225441"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.1050876"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2023.100768"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.149419"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/mr\/road063"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/mr\/roae006"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780310302"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.138461"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hys233"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2007.08.006"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen\u20102021\u2010002139"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.34606"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.110704"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756\u2010185X.13655"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/mr\/roac085"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000003540"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075\u2010022\u201002929\u20100"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/cac2.12283"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1080\/14397595.2020.1869370"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdin.2020.10.013"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdin.2023.07.003"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346\u20108138.14759"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078\u20100432.CCR\u201018\u20101122"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.7326\/M19\u20103369"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.55563\/clinexprheumatol\/staplf"},{"issue":"11","key":"e_1_2_12_41_1","first-page":"2130","article-title":"Skin Cancer, Rheumatoid Arthritis, and Tumor Necrosis Factor Inhibitors","volume":"32","author":"Chakravarty E. F.","year":"2005","journal-title":"Journal of Rheumatology"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i262"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard\u20102022\u2010223636"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12072\u2010018\u20109905\u20107"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075\u2010023\u201003029\u20103"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876\u2010020\u20101158\u2010y"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2019.104585"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar3319"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2023.152301"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcmm.18515"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis\u20102019\u2010216756"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/453012"},{"key":"e_1_2_12_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(09)70035\u2010X"},{"key":"e_1_2_12_54_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102018\u2010021869"},{"key":"e_1_2_12_55_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2009.203000"}],"container-title":["International Journal of Rheumatic Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1756-185x.70363","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1756-185x.70363","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1756-185x.70363","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T10:12:16Z","timestamp":1782123136000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1756-185x.70363"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":54,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1111\/1756-185x.70363"],"URL":"https:\/\/doi.org\/10.1111\/1756-185x.70363","archive":["Portico"],"relation":{},"ISSN":["1756-1841","1756-185X"],"issn-type":[{"value":"1756-1841","type":"print"},{"value":"1756-185X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"2025-02-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70363"}}