WEDNESDAY, March 1 (HealthDay News) -- The elevated lymphoma risk seen in rheumatoid arthritis patients is not related to medication as has been previously suggested, rather, the level of activity of their arthritis more likely affects their cancer risk, according to findings published in the March issue of Arthritis & Rheumatism.
Eva Baecklund, M.D., from Akademiska Hospital in Uppsala, Sweden, and colleagues conducted the largest study to date aimed at understanding the link between rheumatoid arthritis and lymphoma. Using medical records from 74,651 patients, the researchers compared 378 who developed malignant lymphoma to an equal number of controls.
After stratifying the patients into deciles based on arthritis activity tiers, the investigators found that patients in the ninth decile had a 9.4-fold higher risk for lymphoma compared to low activity patients, regardless of their medication. Patients in the tenth decile had a 61.6-fold higher risk compared with low activity patients. Nonsteroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs including methotrexate, and novel immunosuppressive agents like tumor necrosis factor blockers did not seem to affect lymphoma risk.
"High inflammatory activity, rather than its treatment, is a major risk determinant," the authors write. They believe that while most rheumatoid arthritis patients have little risk for lymphoma, those with the very highest level of inflammation have a substantial risk that could be addressed with aggressive treatment.
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