title: Comparing the lifetime risks of TNF-alpha inhibitor use to common benchmarks of risk.
abstract: OBJECTIVE
  The study aims to illustrate the range of lifetime risks of lymphoma, tuberculosis (TB), and demyelinating diseases with TNF-α inhibitors in psoriasis patients.
  
  
  METHODS
  Previously published data and online resources were used to determine the risk of the TB, demyelinating disease, and lymphoma with and without TNF-α inhibitor treatment. Lifetime risks for heart disease and stroke were collected using a Medline search. All cancer, trauma, and environmental statistics were obtained from the data published by National Cancer Institute, National Safety Council, and the National Oceanic and Atmospheric Administration, respectively.
  
  
  RESULTS
  The lifetime risks of TNF-α-inhibitor-linked conditions and comparators are as follows: TNF-α inhibitor-linked conditions: lymphoma with: without TNF-α inhibitors (0.5-4.8%:2.3%), TB with:without TNF-α inhibitors (0-17.1%:0.3%), and demyelinating disease with:without TNF-α inhibitors (0.1-1.7%:0.15%). Comparators: cancer (40.4%), heart disease (36.2%), stroke (18.4%), accidental death (3.0%), motor vehicle death (1.2%), and lightning strike (0.033%).
  
  
  CONCLUSIONS
  Much of the data on lifetime risks of disease with TNF-α inhibitor were for patients with rheumatoid arthritis and not psoriasis.
  
  
  CONCLUSIONS
  The risks of lymphoma, demyelinating diseases, and tuberculosis with TNF-α inhibitors are lower than risks patients face on a regular basis. Screening reduces the risk of tuberculosis in patients receiving TNF-α inhibitors.
authors.affiliation: Department of Dermatology, University of Chicago, 5841 S. Maryland Avenue, MC 5067, Chicago, IL, USA.
authors.forename: Edi
authors.initials: E
authors.lastname: Kaminska
authors.forename: Isha
authors.initials: I
authors.lastname: Patel
authors.forename: Tushar S
authors.initials: TS
authors.lastname: Dabade
authors.forename: Jongwha
authors.initials: J
authors.lastname: Chang
authors.forename: Ayub A
authors.initials: AA
authors.lastname: Qureshi
authors.forename: Jenna L
authors.initials: JL
authors.lastname: O'Neill
authors.forename: Rajesh
authors.initials: R
authors.lastname: Balkrishnan
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
mesh_terms: D000068879:Adalimumab; D000911:Antibodies, Monoclonal / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects; D018501:Antirheumatic Agents / Q000009:adverse effects*; D019985:Benchmarking; D003711:Demyelinating Diseases / Q000139:chemically induced*; D000068800:Etanercept; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects; D000069285:Infliximab; D008223:Lymphoma / Q000139:chemically induced*; D011565:Psoriasis / Q000188:drug therapy; D018124:Receptors, Tumor Necrosis Factor; D018570:Risk Assessment; D012307:Risk Factors; D014376:Tuberculosis / Q000139:chemically induced*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept