Increased Risk of Malignancy With Adalimumab Combination Therapy, Compared With Monotherapy, for Crohn's Disease

Methotrexate Is Not Superior to Placebo for Inducing Steroid-Free Remission, but Induces Steroid-Free Clinical Remission in a Larger Proportion of Patients With Ulcerative Colitis

“…The risk of cancer associated with methotrexate therapy has been assessed in patients with rheumatoid arthritis and most studies have not found an increased risk 22 In comparison, treatment with thio-purines increases the risk of lymphoma and nonmelanoma skin cancer. 3,[23][24][25] Nausea and vomiting were the most common minor adverse events associated with methotrexate therapy.…”

Long‐term safety and efficacy of certolizumab pegol in the treatment of Crohn's disease: 7‐year results from the PRECiSE 3 study

“…26 An analysis of pooled studies found that adalimumab monotherapy was not associated with an increased risk of nonmelanoma skin cancer or other malignancies, whereas adalimumab + immunomodulators (methotrexate or thiopurines) was associated with a five-fold increased risk of nonmelanoma skin cancer and a three-fold increased risk of other malignancies when compared with the general population. 27 Treatment with infliximab is also not associated with an increased risk of malignancies, but combination therapy with immunosuppressants posed a nominally higher risk. 26 In PRECiSE 3, 1 of the 5 patients with nonmelanoma skin cancers was treated with concomitant azathioprine, and none of the others received concomitant immunosuppressants.…”

Editorial: adalimumab or infliximab as monotherapy, or in combination with an immunomodulator, in the treatment of Crohn's disease

“…Unlike with infliximab, prior data supporting the benefits of combination therapy when initiating adalimumab are mixed, 5 and concerns existed regarding adverse events with combination therapy. 7 Importantly, this study provides evidence that, at least during short-term follow-up, combination therapy is as safe as monotherapy. In fact, patients on combination therapy with either anti-TNF agent developed less adverse events (especially allergic and dermatological reactions) than monotherapy patients.…”

“…Patients with tumour-induced complications were rightly excluded due to the impact on outcome thus yielding a cleaner cohort of patients, and have been previously reported by this group. 7 The results of this study should be interpreted with some caution due to the retrospective nature over a long time period obviously introducing the possibilities of an 'era' effect. Patients had a mean follow-up after TIPSS of 27.4 months (AE30.6), a relatively short mean follow-up during a decade's worth of data.…”