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Life sciences · Journal article
Arthritis & Rheumatology · August 17, 2026
Well-designed and adequately powered for the question it asks.
This nationwide cohort study of 56,591 patients with spondyloarthritis found no increased overall cancer risk with prolonged (>6 months/year) exposure to targeted therapies compared with shorter exposure. Exposure >6 months annually was associated with lower cancer risk overall (HR 0.86) and specifically for hematological malignancies (HR 0.65), while cumulative exposure over multiple years was not associated with cancer risk.
Nationwide cohort study using health insurance database with weighted Cox marginal structural models. Adults with spondyloarthritis (psoriatic arthritis, axial SpA, other subtypes) initiating targeted therapy; excluded prior cancer, HIV infection, or organ transplantation; identified from French health insurance database. Intervention: Targeted therapy exposure >6 months per year (TNFi, IL17i, IL12/23i, IL23i, JAKi). Compared with: Targeted therapy exposure ≤6 months per year. n = 56,591. France (nationwide cohort from French health insurance database).
56,591 patients with spondyloarthritis enrolled; 1,224 cancers occurred during median 5.0-year follow-up (1,029 solid, 116 hematological, 79 unclassified) Exposure >6 versus ≤6 months per year associated with lower overall cancer risk: weighted HR 0.86 (95% CI 0.75–0.99) For hematological malignancies: weighted HR 0.65 (95% CI 0.42–0.99) with >6 months exposure
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
For clinicians managing spondyloarthritis with targeted therapies, this large cohort study provides reassurance that prolonged exposure is not associated with increased cancer risk, supporting use of these agents without cancer-related restrictions based on treatment duration alone. The unexpected lower risk with longer exposure warrants cautious interpretation and may reflect healthy-user bias or surveillance effects rather than protective mechanisms.
Large nationwide cohort study with 56,591 patients and 1,224 cancer events using weighted Cox models to address confounding, showing no increased cancer risk with prolonged targeted therapy exposure in spondyloarthritis.
As stated by the source record.
Quoted from the source exactly as published.
For clinicians managing spondyloarthritis with targeted therapies, this large cohort study provides reassurance that prolonged exposure is not associated with increased cancer risk, supporting use of these agents without cancer-related restrictions based on treatment duration alone. The unexpected lower risk with longer exposure warrants cautious interpretation and may reflect healthy-user bias or surveillance effects rather than protective mechanisms.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
OBJECTIVE: To assess the association between duration of targeted therapy exposure and cancer risk in patients with spondyloarthritis (SpA), including those with psoriatic arthritis, axial SpA, and other subtypes. METHODS: This nationwide cohort study used the French health insurance database to identify adults with SpA initiating a targeted therapy (TNFi, IL17i, IL12/23i, IL23i, JAKi) from January 2014 to September 2022. Patients with prior cancer, HIV infection, or organ transplantation were excluded. Follow-up began after a 3-month delay and continued until December 2024. Exposure was assessed annually and classified as ≤6 or >6 months per year. Incident cancer was the primary outcome. Weighted Cox marginal structural models with inverse probability of treatment and censoring weights were used. A post hoc sensitivity analysis evaluated cumulative exposure trajectories over time. RESULTS: We included 56,591 patients (53.9% women; mean age 44±13 years; median follow-up 5.0 years). During follow-up, 1,224 cancers occurred (1,029 solid, 116 hematological, 79 unclassified). Exposure >6 versus ≤6 months was associated with a lower risk of overall cancer (weighted HR 0.86, 95%CI 0.75-0.99). In subgroup analyses, this association was observed for hematological malignancies (wHR 0.65, 95%CI 0.42-0.99) but not for solid cancers (wHR 0.92, 95%CI 0.79-1.07). Cumulative exposure history was not associated with cancer risk. CONCLUSION: In this nationwide study, prolonged exposure to targeted therapies was not associated with an increased cancer risk. Exposure >6 months per year was associated with a lower cancer risk, mainly for hematological malignancies, whereas cumulative exposure over multiple years was not associated with cancer risk.
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