{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:04:09Z","timestamp":1788951849988,"version":"build-2803163510"},"reference-count":40,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T00:00:00Z","timestamp":1671753600000},"content-version":"unspecified","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004785","name":"NordForsk","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004785","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014034","name":"Foundation for Research in Rheumatology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014034","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the risk of haematological malignancies in patients with psoriatic arthritis (PsA) overall, and in relation to treatment with tumour necrosis factor inhibitors (TNFi).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified that patients with PsA starting a first TNFi from the clinical rheumatology registers (CRR) in the five Nordic countries (n=10 621) and biologics-na\u00efve PsA patients from (1) the CRR (n=18 705) and (2) the national patient registers (NPR, n=27 286, Sweden and Denmark) from 2006 through 2019. For Sweden and Denmark, general population comparators were matched 5:1 to PsA patients on birth year, year at start of follow-up and sex. By linkage to the national cancer registers in all countries, we collected information on haematological malignancies overall, and categorised into lymphoid or myeloid types. We estimated incidence rate ratios (IRRs) with 95% CIs using modified Poisson regression for TNFi-treated versus biologics-na\u00efve PsA patients and versus the general population adjusted for age, sex, calendar period and country.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During 59 827 person-years, 40 haematological malignancies occurred among TNFi-treated patients with PsA resulting in a pooled IRR of 0.96 (0.68\u20131.35) versus biologics-na\u00efve PsA from CRR and an IRR of 0.84 (0.64\u20131.10) versus biologics-na\u00efve PsA from NPR. The IRR of haematological malignancies in PsA overall versus general population comparators was 1.35 (1.17\u20131.55). The estimates were largely similar for lymphoid and myeloid malignancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Treatment with TNFi in patients with PsA was not associated with an increased incidence of haematological malignancies. Conversely, a moderately increased underlying risk was seen in patients with PsA compared with the general population.<\/jats:p><\/jats:sec>","DOI":"10.1136\/rmdopen-2022-002776","type":"journal-article","created":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T14:45:16Z","timestamp":1671806716000},"page":"e002776","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Haematological malignancies in patients with psoriatic arthritis overall and treated with TNF inhibitors: a Nordic cohort study"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5271-2574","authenticated-orcid":false,"given":"Rene Lindholm","family":"Cordtz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0433-0616","authenticated-orcid":false,"given":"Johan","family":"Askling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2716-5679","authenticated-orcid":false,"given":"Benedicte","family":"Delcoigne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin E","family":"Smedby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Baecklund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Ballegaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Isom\u00e4ki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalle","family":"Aaltonen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4631-6505","authenticated-orcid":false,"given":"Bjorn","family":"Gudbjornsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thorvardur Jon","family":"Love","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5442-902X","authenticated-orcid":false,"given":"Sella Aarrestad","family":"Provan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte","family":"Michelsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Sexton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lene","family":"Dreyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7149-0973","authenticated-orcid":false,"given":"Karin","family":"Hellgren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,12,23]]},"reference":[{"key":"2022122306451225000_8.2.e002776.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semcancer.2013.12.001"},{"key":"2022122306451225000_8.2.e002776.2","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.beha.2019.02.002","article-title":"Myeloid disorders after autoimmune disease","volume":"32","author":"Boddu","year":"2019","journal-title":"Best Pract Res Clin Haematol"},{"key":"2022122306451225000_8.2.e002776.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2008.02029.x"},{"key":"2022122306451225000_8.2.e002776.4","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-015-0728-9"},{"key":"2022122306451225000_8.2.e002776.5","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1002\/hon.2525","article-title":"Rheumatoid arthritis and lymphoma: incidence, pathogenesis, biology, and outcome","volume":"36","author":"Klein","year":"2018","journal-title":"Hematol Oncol"},{"key":"2022122306451225000_8.2.e002776.6","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.34.8540"},{"key":"2022122306451225000_8.2.e002776.7","doi-asserted-by":"crossref","first-page":"E280","DOI":"10.1002\/ajh.24333","article-title":"Autoimmune diseases and myelodysplastic syndromes","volume":"91","author":"Komrokji","year":"2016","journal-title":"Am J Hematol"},{"key":"2022122306451225000_8.2.e002776.8","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1016\/j.canep.2014.08.003","article-title":"Relative risk of myelodysplastic syndromes in patients with autoimmune disorders in the general practice research database","volume":"38","author":"Wilson","year":"2014","journal-title":"Cancer Epidemiol"},{"key":"2022122306451225000_8.2.e002776.9","doi-asserted-by":"crossref","first-page":"1472","DOI":"10.1002\/art.38385","article-title":"A comparison of the malignancy incidence among patients with psoriatic arthritis and patients with rheumatoid arthritis in a large US cohort","volume":"66","author":"Gross","year":"2014","journal-title":"Arthritis Rheumatol"},{"key":"2022122306451225000_8.2.e002776.10","doi-asserted-by":"publisher","DOI":"10.1002\/art.23185"},{"key":"2022122306451225000_8.2.e002776.11","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1002\/art.38339","article-title":"Ankylosing spondylitis, psoriatic arthritis, and risk of malignant lymphoma: a cohort study based on nationwide prospectively recorded data from Sweden","volume":"66","author":"Hellgren","year":"2014","journal-title":"Arthritis Rheumatol"},{"key":"2022122306451225000_8.2.e002776.12","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1097\/RHU.0000000000000364","article-title":"Rates of cancers and opportunistic infections in patients with psoriatic arthritis compared with patients without psoriatic arthritis","volume":"22","author":"Hagberg","year":"2016","journal-title":"J Clin Rheumatol"},{"key":"2022122306451225000_8.2.e002776.13","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1007\/s10067-016-3396-5","article-title":"Malignancy incidence in patients with psoriatic arthritis: a comparison cohort-based incidence study","volume":"35","author":"Wilton","year":"2016","journal-title":"Clin Rheumatol"},{"key":"2022122306451225000_8.2.e002776.14","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.semarthrit.2020.12.008","article-title":"Malignancy in psoriatic disease: results from prospective longitudinal cohorts","volume":"51","author":"Polachek","year":"2021","journal-title":"Semin Arthritis Rheum"},{"key":"2022122306451225000_8.2.e002776.15","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1001\/jamadermatol.2020.0024","article-title":"Prevalence, incidence, and risk of cancer in patients with psoriasis and psoriatic arthritis: a systematic review and meta-analysis","volume":"156","author":"Vaengebjerg","year":"2020","journal-title":"JAMA Dermatol"},{"key":"2022122306451225000_8.2.e002776.16","doi-asserted-by":"publisher","DOI":"10.1002\/art.21675"},{"key":"2022122306451225000_8.2.e002776.17","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-202099"},{"key":"2022122306451225000_8.2.e002776.18","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20218"},{"key":"2022122306451225000_8.2.e002776.19","doi-asserted-by":"crossref","first-page":"700.1","DOI":"10.1136\/annrheumdis-2020-217159","article-title":"EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update","volume":"79","author":"Gossec","year":"2020","journal-title":"Ann Rheum Dis"},{"key":"2022122306451225000_8.2.e002776.20","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1186\/s13075-019-1916-9","article-title":"Etanercept treatment for extended oligoarticular juvenile idiopathic arthritis, enthesitis-related arthritis, or psoriatic arthritis: 6-year efficacy and safety data from an open-label trial","volume":"21","author":"Foeldvari","year":"2019","journal-title":"Arthritis Res Ther"},{"key":"2022122306451225000_8.2.e002776.21","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1007\/s12325-019-01145-8","article-title":"Long-Term safety of adalimumab in 29,967 adult patients from global clinical trials across multiple indications: an updated analysis","volume":"37","author":"Burmester","year":"2020","journal-title":"Adv Ther"},{"key":"2022122306451225000_8.2.e002776.22","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2019-000942"},{"key":"2022122306451225000_8.2.e002776.23","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1016\/j.semarthrit.2018.05.009","article-title":"Malignancy development risk in psoriatic arthritis patients undergoing treatment: a systematic review and meta-analysis","volume":"48","author":"Luo","year":"2019","journal-title":"Semin Arthritis Rheum"},{"key":"2022122306451225000_8.2.e002776.24","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-209270"},{"key":"2022122306451225000_8.2.e002776.25","doi-asserted-by":"crossref","first-page":"3656","DOI":"10.1093\/rheumatology\/keaa828","article-title":"Risk of solid cancers overall and by subtypes in patients with psoriatic arthritis treated with TNF inhibitors - a Nordic cohort study","volume":"60","author":"Hellgren","year":"2021","journal-title":"Rheumatology"},{"key":"2022122306451225000_8.2.e002776.26","doi-asserted-by":"crossref","unstructured":"Chatzidionysiou K , Hetland ML , Frisell T , et al . Opportunities and challenges for real-world studies on chronic inflammatory joint diseases through data enrichment and collaboration between national registers: the Nordic example. RMD Open 2018;4:e000655.doi:10.1136\/rmdopen-2018-000655","DOI":"10.1136\/rmdopen-2018-000655"},{"key":"2022122306451225000_8.2.e002776.27","doi-asserted-by":"crossref","unstructured":"Waldenlind K , Eriksson JK , Grewin B , et al . Validation of the rheumatoid arthritis diagnosis in the Swedish national patient register: a cohort study from Stockholm County. BMC Musculoskelet Disord 2014;15:432.doi:10.1186\/1471-2474-15-432","DOI":"10.1186\/1471-2474-15-432"},{"key":"2022122306451225000_8.2.e002776.28","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S91125"},{"key":"2022122306451225000_8.2.e002776.29","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-11-450"},{"key":"2022122306451225000_8.2.e002776.30","doi-asserted-by":"publisher","DOI":"10.1080\/02841860802247664"},{"key":"2022122306451225000_8.2.e002776.31","doi-asserted-by":"publisher","DOI":"10.1177\/1403494810393562"},{"key":"2022122306451225000_8.2.e002776.32","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.140853"},{"key":"2022122306451225000_8.2.e002776.33","doi-asserted-by":"publisher","DOI":"10.3109\/0284186X.2012.698751"},{"key":"2022122306451225000_8.2.e002776.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2008.10.037"},{"key":"2022122306451225000_8.2.e002776.35","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1294"},{"key":"2022122306451225000_8.2.e002776.36"},{"key":"2022122306451225000_8.2.e002776.37","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-01-293050"},{"key":"2022122306451225000_8.2.e002776.38","unstructured":"Swerdlow SH , Campo E , Harris NL , et al . Who classification of tumours of haematopoietic and lymphoid tissues. Lyon, France: IARC Press, 2008."},{"key":"2022122306451225000_8.2.e002776.39","doi-asserted-by":"publisher","DOI":"10.1002\/sim.2764"},{"key":"2022122306451225000_8.2.e002776.40","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-201244"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2022-002776","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T14:45:27Z","timestamp":1671806727000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2022-002776"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12]]},"references-count":40,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,12,23]]},"published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1136\/rmdopen-2022-002776"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2022-002776","relation":{},"ISSN":["2056-5933"],"issn-type":[{"value":"2056-5933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12]]}}}