Lymphoma risk in inflammatory bowel disease: Is it the disease or its treatment?

Jones, Jennifer; Loftus, Edward V.

doi:10.1002/ibd.20211

Cited by 111 publications

(69 citation statements)

References 82 publications

(137 reference statements)

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“…An analysis of the Th erapy, Resource, Evaluation, and Assessment Tool registry has not found an increased risk of malignancy, though the mean follow-up to date is only 2 years ( 170 ). However, multiple analyses indicate an increased risk of lymphoma ( 176 ). In rheumatoid arthritis, a meta-analysis found 10 patients with lymphoma in 3,500 infl iximab-treated patients, compared to none in 1,500 control patients ( 171 ).…”

Section: Infl Iximabmentioning

confidence: 99%

“…However, experience with the thiopurines over the last four decades indicates that there is not an increased risk of the development of solid tumors (as discussed above) ( 201 ) or overall mortality ( 200,238 ). Conversely, a recent meta-analysis of six cohort studies calculated a fourfold increased risk of lymphoma among IBD patients treated with thiopurines, but it remains unclear whether this risk was due to the medications themselves or due to the underlying disease ( 176,180,239 ).…”

Section: The Patient With Severe Colitis Refractory To Maximal Oral Tmentioning

confidence: 99%

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Ulcerative Colitis Practice Guidelines in Adults: American College of Gastroenterology, Practice Parameters Committee

Kornbluth

Sachar

2010

American Journal of Gastroenterology

1,156

977

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Guidelines for clinical practice are aimed to indicate preferred approaches to medical problems as established by scientifi cally valid research. Double-blind placebo controlled studies are preferable, but compassionate-use reports and expert review articles are used in a thorough review of the literature conducted through Medline with the National Library of Medicine. When only data that will not withstand objective scrutiny are available, a recommendation is identifi ed as a consensus of experts. Guidelines are applicable to all physicians who address the subject regardless of specialty training or interests and are aimed to indicate the preferable but not necessarily the only acceptable approach to a specifi c problem. Guidelines are intended to be fl exible and must be distinguished from standards of care, which are infl exible and rarely violated. Given the wide range of specifi cs in any healthcare problem, the physician must always choose the course best suited to the individual patient and the variables in existence at the moment of decision. Guidelines are developed under the auspices of the American College of Gastroenterology and its Practice Parameters Committee and approved by the board of trustees. Each has been intensely reviewed and revised by the Committee, other experts in the fi eld, physicians who will use them, and specialists in the science of decision analysis. The recommendations of each guideline are therefore considered valid at the time of composition based on the data available. New developments in medical research and practice pertinent to each guideline will be reviewed at a time established and indicated at publication to assure continued validity. The recommendations made are based on the level of evidence found. Grade A recommendations imply that there is consistent level 1 evidence (randomized controlled trials), grade B indicates that the evidence would be level 2 or 3, which are cohort studies or case -control studies. Grade C recommendations are based on level 4 studies, meaning case series or poor-quality cohort studies, and grade D recommendations are based on level 5 evidence, meaning expert opinion.

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Section: Infl Iximabmentioning

confidence: 99%

Section: The Patient With Severe Colitis Refractory To Maximal Oral Tmentioning

confidence: 99%

Ulcerative Colitis Practice Guidelines in Adults: American College of Gastroenterology, Practice Parameters Committee

Kornbluth

Sachar

2010

American Journal of Gastroenterology

1,156

977

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“…The long-term risk of malignancy is not established, but there are reports of an increased occurrence of malignancy in patients with MG and other autoimmune diseases receiving immunosuppression [44,45], so the minimal dose of immunosuppressant medications required to maintain control of the disease should be used.…”

Section: Present Management Of Autoimmune Mgmentioning

confidence: 99%

Current Treatment, Emerging Translational Therapies, and New Therapeutic Targets for Autoimmune Myasthenia Gravis

2016

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Myasthenia gravis (MG) is an autoimmune disease associated with the production of autoantibodies against 1) the skeletal muscle acetylcholine receptor; 2) muscle-specific kinase, a receptor tyrosine kinase critical for the maintenance of neuromuscular synapses; 3) low-density lipoprotein receptor-related protein 4, an important molecular binding partner for muscle-specific kinase; and 4) other muscle endplate proteins. In addition to the profile of autoantibodies, MG may be classified according the location of the affected muscles (ocular vs generalized), the age of symptom onset, and the nature of thymic pathology. Immunopathologic events leading to the production of autoantibodies differ in the various disease subtypes. Advances in our knowledge of the immunopathogenesis of the subtypes of MG will allow for directed utilization of the ever-growing repertoire of therapeutic agents that target distinct nodes in the immune pathway relevant to the initiation and maintenance of autoimmune disease. In this review, we examine the pathogenesis of MG subtypes, current treatment options, and emerging new treatments and therapeutic targets.

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“…Although the etiopathogenesis for UC is not exactly defined, improved understanding of the immunopathogenesis of IBD has resulted in significant advances in the research and development of immunosuppressive and biologic agents [Jones and Loftus, 2007]. Currently, infliximab, a chimeric IgG 1 monoclonal antibody to tumor necrosis factor-alpha (TNF-a), has demonstrated efficacy for the induction and maintenance of remission in moderate to severe UC [Rutgeerts et al 2005].…”

mentioning

confidence: 99%

“…As the utilization of infliximab for UC has increased, there has been increasing concern about its long-term safety given its immunosuppressive effects. Specifically, the increased risk of malignancy, in particular lymphoma, has been an area of controversy and debate [Biancone et al 2007;Jones and Loftus, 2007;Reddy and Loftus, 2006].…”

mentioning

confidence: 99%

Ulcerative colitis, infliximab, and hepatic epithelioid hemangioendothelioma: who is to blame? Case Report

Chang

Marks

Nagorney

et al. 2010

Therap Adv Gastroenterol

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Epithelioid hemangioendothelioma (EH) is a rare vascular neoplasm that was first described by Weiss and Enzinger [1982]. The natural history and clinical course of EH is largely unknown given its rarity, but its malignant potential is thought to range between that of a benign hemangioma to a malignant angiosarcoma [Woodall et al. 2008;Mehrabi et al. 2006;Uchimura et al. 2001]. Primary disease can involve soft tissue and visceral organs to include heart, spleen, lung, bone, and lymph nodes [Woodall et al. 2008;Mehrabi et al. 2006]. Primary malignant hepatic epithelioid hemangioendothelioma (HEH) is an exceptionally rare tumor with a reported incidence of less than 0.1 per 100,000, with less than 440 published reports in the literature [Mehrabi et al. 2006]. The exact etiopathogenesis of HEH is unknown but possible etiologic factors have been described to include oral contraceptives, vinyl chloride, asbestos, hepatic trauma, viral hepatitis, primary biliary cirrhosis, and alcohol consumption [Mehrabi et al. 2006].

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Lymphoma risk in inflammatory bowel disease: Is it the disease or its treatment?

Cited by 111 publications

References 82 publications

Ulcerative Colitis Practice Guidelines in Adults: American College of Gastroenterology, Practice Parameters Committee

Ulcerative Colitis Practice Guidelines in Adults: American College of Gastroenterology, Practice Parameters Committee

Current Treatment, Emerging Translational Therapies, and New Therapeutic Targets for Autoimmune Myasthenia Gravis

Ulcerative colitis, infliximab, and hepatic epithelioid hemangioendothelioma: who is to blame? Case Report

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