Vedolizumab, TNF blockers for IBD pose no new or recurrent cancer risk
Among inflammatory bowel disease (IBD) patients with a current or prior malignancy, treatment with vedolizumab (VDZ) or antitumour necrosis factor (anti-TNF) does not bear an increased hazard of developing new or recurrent cancer, as shown in a study.
The analysis included 463 IBD patients, among whom 96 patients were exposed to VDZ (mean duration, 1.7 person-years) after a diagnosis of cancer and 184 to anti-TNF (mean duration, 3.6 person-years). Some 183 patients received no immunosuppression therapy.
Half of the overall population had solid tumours as the primary cancer. Over a median of 6.2 person-years of follow-up, cancer events occurred in 18 patients on VDZ (new, n=7; recurrent, n=11), 61 patients on anti-TNF (new, n=27; recurrent, n=34), and 78 controls (new, n=30; recurrent, n=48). The corresponding incidence rates were 2.2, 4.2, and 5.6 per 1,000 person-years.
Multivariable Cox analysis revealed that the risk of developing new or recurrent cancer did not increase following exposure to VDZ (hazard ratio [HR], 1.38, 95 percent confidence interval [CI], 0.38–1.36) or anti-TNF therapy (HR, 1.03, 95 percent CI, 0.65–1.64) relative to no immunosuppression.
Analysis by biologic exposure time yielded similar results. Compared with anti-TNF, VDZ did not confer a risk increase in cancer events (HR, 0.82, 95 percent CI, 0.45–1.49).
The findings provide reassurance regarding the use of VDZ in the present population, as well as provide further evidence of the safety of anti-TNF therapy.