Comparative Safety of Biologic Agents in Patients With Inflammatory Bowel Disease With Active or Recent Malignancy: A Multi-Center Cohort Study

Holmer, Ariela; Luo, Jiyu; Russ, Kirk; Park, Sarah; Yang, Jeong Yun; Ertem, Furkan U.; Dueker, Jeffrey; Nguyen, Vu Q.; Hong, Simon; Zenger, Cameron; Axelrad, Jordan E.; Sofia, M. Anthony; Petrov, Jessica C.; Al-Bawardy, Badr; Fudman, David; Llano, Ernesto M.; Dailey, Joseph; Jangi, Sushrut; Khakoo, Nidah S.; Damas, Oriana M.; Barnes, Edward L.; Scott, Frank I.; Ungaro, Ryan C.; Singh, Siddharth

doi:10.1016/j.cgh.2023.01.002

Cited by 10 publications

(9 citation statements)

References 20 publications

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“…In patients with active cancer, the PFS in patients exposed to TNFi was similar to the PFS of patients exposed to non-TNFα biologics (HR = 0.76; 95% CI, 0.25-2.30; p = 0.62) [210]. Again, in patients with prior cancer, there was no difference in the risk of recurrence-free survival (RFS) between patients exposed to TNFi vs non-TNFα biologics (HR = 0.94; 95% CI, 0.24-3.77) [210]. TNFi and non-TNFα biologics exhibit similar safety profiles, with a generally low risk of cancer progression and recurrence [210].…”

Section: Therapy Management With Immunomodulators and Biologic Agents...mentioning

confidence: 71%

Section: Therapy Management With Immunomodulators and Biologic Agents...mentioning

confidence: 99%

“…Holmer et al conducted a comparison between the safety of TNFi and other classes of biologics or IMM (VDZ, UST, thiopurines, and MTX) in patients with IBD and current or prior cancer [210]. In patients with active cancer, the PFS in patients exposed to TNFi was similar to the PFS of patients exposed to non-TNFα biologics (HR = 0.76; 95% CI, 0.25-2.30; p = 0.62) [210]. Again, in patients with prior cancer, there was no difference in the risk of recurrence-free survival (RFS) between patients exposed to TNFi vs non-TNFα biologics (HR = 0.94; 95% CI, 0.24-3.77) [210].…”

Section: Therapy Management With Immunomodulators and Biologic Agents...mentioning

confidence: 99%

“…Again, in patients with prior cancer, there was no difference in the risk of recurrence-free survival (RFS) between patients exposed to TNFi vs non-TNFα biologics (HR = 0.94; 95% CI, 0.24-3.77) [210]. TNFi and non-TNFα biologics exhibit similar safety profiles, with a generally low risk of cancer progression and recurrence [210].…”

Section: Therapy Management With Immunomodulators and Biologic Agents...mentioning

confidence: 99%

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Extraintestinal Cancers in Inflammatory Bowel Disease: A Literature Review

Massano

Bertin

Zingone

et al. 2023

Cancers

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Background: Inflammatory bowel disease (IBD) is a group of chronic multifactorial inflammatory disorders including two major entities: Crohn’s disease (CD) and ulcerative colitis (UC). Preliminary evidence suggests that patients with IBD may be at increased risk of developing intestinal and extraintestinal cancers (EICs). Actually, little is known about the association between IBD and EICs, and there is ever-growing concern regarding the safety of immunomodulators and biological therapy, which may represent a risk factor for carcinogenesis. Aims: The aim of this review is to summarize the evidence regarding the association between IBD and EICs, the safety of immunomodulators and biological therapy and the management of immunomodulators and biologic agents in IBD patients with prior or current EICs. Results: IBD patients have a higher risk of developing different forms of extraintestinal solid organ tumors and hematological malignancies. Immunomodulators and biological therapy may increase the risk of developing some types of EICs and may be consciously used in patients with IBD and current or prior history of malignancy. Conclusions: Decisions regarding the use of immunomodulators or biological therapies should be made on an individual basis, considering a multidisciplinary approach involving oncologists.

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Section: Therapy Management With Immunomodulators and Biologic Agents...mentioning

confidence: 71%

Section: Therapy Management With Immunomodulators and Biologic Agents...mentioning

confidence: 99%

Section: Therapy Management With Immunomodulators and Biologic Agents...mentioning

confidence: 99%

Section: Therapy Management With Immunomodulators and Biologic Agents...mentioning

confidence: 99%

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Extraintestinal Cancers in Inflammatory Bowel Disease: A Literature Review

Massano

Bertin

Zingone

et al. 2023

Cancers

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“…In patients with IBD with a prior history of cancer, immunosuppression exposure including anti-TNF did not result in higher incidences of malignancy, either new or recurrent [47]. Furthermore, in IBD patients with cancer, exposure to anti-TNF and other biologics did not influence the risk of cancer progression-free survival [48 ▪ ]. This further exemplifies the importance of properly treating all older adults with IBD and highlights the need for more studies in this area.…”

Section: Treatment and Disease Attributed Malignancy Riskmentioning

confidence: 74%

Managing the older adult with inflammatory bowel disease: is age just a number?

Bermudez

Faye

Kochar

2023

Current Opinion in Gastroenterology

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Purpose of reviewThis review summarizes the most recent literature on older adults with inflammatory bowel diseases (IBD). Additionally, we review geriatric syndromes that may be pertinent to the management of older adults with IBD.Recent findingsTraditionally chronological age has been used to risk stratify older adults with IBD, however physiologic status, including comorbidities, frailty, and sarcopenia, are more closely associated with clinical outcomes for older adults. Delaying care for and undertreating older adults with IBD based upon advanced chronologic age alone is associated with worse outcomes, including increased mortality. Treatment decisions should be made considering physiologic status, with an understanding of the differential risks associated with both ongoing disease and treatment. As such, there is an increasing recognition of the impact geriatric syndromes have on older adults with IBD, which need to be further explored.SummaryOlder adults with IBD are less likely to receive advanced therapies and timely surgery. They are also more likely to have adverse outcomes despite having similar disease courses to younger adults with IBD. Focusing on biological age as opposed to chronological age can shift this trajectory and improve quality of care for this growing population of patients with IBD.

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