Immunosuppressants found safe for IBD patients with cancer history

Last Updated: 2019-04-30

By Reuters Staff

NEW YORK (Reuters Health) - Immunosuppressant therapies (IMTs) do not appear to increase the risk of new or recurrent cancers in inflammatory bowel disease (IBD) patients with a history of cancer unrelated to immunosuppression, new findings show.

"Despite the lack of specific guidelines on this issue, the results of the present study suggest that starting IMT in patients with a cancer that is unrelated to immunosuppression (who have never been exposed to these drugs) seems to be safe," researchers write in in the American Journal of Gastroenterology, online April 8.

"In our opinion, previous exposure to IMT should be addressed in depth in future studies and should be taken into account for developing a new recommendation consensus," add Dr. Miriam Manosa of HU Germans Trias I Pujol in Badalona, Spain, and colleagues.

The authors looked at data from the Spanish Working Group in IBD's ENEIDA registry on 520 IBD patients who had not been exposed to IMT before their cancer diagnosis, including 146 (27%) subsequently treated with thiopurines and/or anti-tumor necrosis factor (TNF) and 374 (73%) who were not exposed to IMT during follow-up.

Among the exposed patients, 62% received thiopurines alone, 34% thiopurines and anti-TNF combined and 4% anti-TNF only.

Incident cancers occurred in 16% of the exposed group and 18% of the unexposed group. Exposed patients' cancer-free survival was 99% at one year, 98% at two years, and 97% at five years, while it was 97%, 96% and 92% in the unexposed patients. (p=0.03).

"The present study confirms that IMT in patients with IBD can be safely used beyond 5 years after cancer diagnosis and that IMTs (including thiopurines alone or in combination with anti-TNF agents) do not seem to increase the risk of new or recurrent cancers in this subset of patients," the researchers conclude.

AbbVie, Takeda, Pfizer, Kern Pharmaceuticals and MSD fund the ENEIDA registry, and Dr. Manosa and several coauthors report financial relationships with several pharmaceutical companies.

Dr. Manosa was not available for an interview by press time.

SOURCE: https://bit.ly/2GRkp6Y

Am J Gastroenterol 2019.