OP0187 INCIDENCE OF MALIGNANCY IN JAPANESE PATIENTS WITH RHEUMATOID ARTHRITIS: DATA FROM THE JAPANESE IORRA PATIENT REGISTRY
Authors: M. Harigai, N. Sugitani, R. Sakai, E. Inoue, M. Mochizuki, S. Toyoizumi, N. Yoshii, N. Sugiyama, E. Tanaka, H. Yamanaka
Journal: Annals of the Rheumatic Diseases (2021)

Background: The risk of some types of malignancy is increased in patients (pts) with rheumatoid arthritis (RA), compared with the general population. We have previously reported the incidence of malignancy in Japanese pts with RA. 1-4 Objectives: This analysis further evaluated the incidence of malignancy in Japanese pts with RA using recent data from the large prospective observational study, IORRA. Methods: This analysis included all pts with RA aged ≥18 years who were enrolled in IORRA from April 2013 to October 2018, with follow-up through October 2019, and participated in ≥2 surveys. Index was defined as the date of the first entry in the IORRA database, with baseline defined as the 6-month period prior to the index date. Malignancies were identified in pt reports of biannual IORRA surveys and confirmed using medical records. Age- and sex-standardised incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated. Results: In total, 8020 pts were included. At baseline, the majority (85.0%) of pts were female; mean disease duration was 12.8 years, 5.8% and 4.8% of pts had a past history of malignancy or comorbid malignancy at baseline, respectively, and the majority (75.9%) of pts were receiving methotrexate (Table). The SIR (95% CI) was 0.90 (0.80, 1.01). SIRs (95% CI) of site-specific malignancies were: breast cancer, 0.91 (0.69, 1.18); lung cancer, 0.67 (0.44, 0.97); colon cancer, 0.93 (0.62, 1.32); stomach cancer, 0.82 (0.56, 1.14); and lymphoma, 3.74 (2.73, 4.96). Table 1. Patient demographics and baseline disease characteristics Patients with RA (N=8020 ) Age (years), mean (SD) 59.3 (13.8) Female, n (%) 6816 (85.0) Duration of RA (years), mean (SD) 12.8 (10.3) Never smoked, n (%) 5086 (66.2) DAS28, mean (SD) 2.8 (1.1) J-HAQ, mean (SD) 0.60 (0.72) Malignancy status, n (%) Past history of malignancy 467 (5.8) Comorbid malignancy at baseline 386 (4.8) Medication use, n (%) MTX 6088 (75.9) Tacrolimus 787 (9.8) Corticosteroids 2641 (32.9) bDMARD use 1508 (18.8) TNFi 1163 (14.5) Tocilizumab 311 (3.9) Abatacept 106 (1.3) JAK inhibitors 4 (0.05) bDMARD, biological disease-modifying antirheumatic drug; DAS28, Disease Activity Score in 28 joints; JAK, Janus kinase; J-HAQ, Japanese Health Assessment Questionnaire; MTX, methotrexate; N, the number of patients included in the analysis, the number of patients assessed for each characteristic may be fewer than N; n, the number of patients with each characteristic; SD, standard deviation; TNFi, tumour necrosis factor inhibitor Conclusion: Overall risk of malignancy was similar to that in the general Japanese population, although a significantly higher risk of lymphoma was identified. References: [1]Sugimoto et al. Rheumatol Int 2017; 37: 1871-1878. [2]Shimizu et al. Clin Rheumatol 2017; 36: 1237-1245. [3]Askling et al. Ann Rheum Dis 2016; 75: 1789-1796. [4]Yamada et al. Rheumatol Int 2011; 31: 1487-1492. Acknowledgements: Study sponsored by Pfizer Inc. Medical writing support was provided by Anthony G McCluskey, CMC Connect, and funded by Pfizer Inc. Disclosure of Interests: masayoshi harigai Speakers bureau: AbbVie Japan, Ayumi, Boehringer Ingelheim Japan, Bristol-Myers Squibb, Chugai, Eisai, Eli Lilly Japan, GlaxoSmithKline, Kissei, Pfizer Japan Inc, Takeda, Teijin, Consultant of: AbbVie Japan, Boehringer Ingelheim Japan, Bristol-Myers Squibb, Kissei, Teijin, Grant/research support from: AbbVie Japan, Asahi Kasei, Astellas, Ayumi, Bristol-Myers Squibb, Chugai, Daiichi-Sankyo, Eisai, Kissei, Mitsubishi Tanabe, Nippon Kayaku, Sekiui Medical, Shionogi, Taisho, Takeda, Teijin, Naohiro Sugitani: None declared, Ryoko Sakai Speakers bureau: Bristol-Myers Squibb, Eisuke Inoue Speakers bureau: Pfizer Japan Inc, Bristol-Myers Squibb, Michika MOCHIZUKI Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Shigeyuki Toyoizumi Employee of: Pfizer R&amp;D Japan, Noritoshi Yoshii Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Naonobu Sugiyama Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Eiichi Tanaka Speakers bureau: AbbVie Japan, Asahi Kasei, Astellas, Ayumi, Chugai, Eisai, Eli Lilly Japan, GlaxoSmithKline, Kyowa, Janssen, Mochida, Pfizer Japan Inc, Takeda, Teijin, Hisashi Yamanaka Speakers bureau: Astellas, Bristol-Myers-Squibb, Pfizer Inc, Mitsubishi Tanabe, Teijin, YLBio, Consultant of: Corrona, LLC