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Review

Treatment of sarcoidosis: grading the evidence

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Pages 677-687 | Received 17 Jan 2018, Accepted 06 Jun 2018, Published online: 18 Jun 2018

References

  • Walsh SL, Wells AU, Sverzellati N, et al. An integrated clinicoradiological staging system for pulmonary sarcoidosis: a case-cohort study. Lancet Respir Med. 2014;2(2):123–130.
  • Kirkil G, Lower EE, Baughman RP. Predictors of mortality in pulmonary sarcoidosis. Chest. 2017;17:10.
  • Uzunhan Y, Nunes H, Jeny F, et al. Chronic pulmonary aspergillosis complicating sarcoidosis. Eur Respir J. 2017;49(6):1602396.
  • Lower EE, Broderick JP, Brott TG, et al. Diagnosis and management of neurologic sarcoidosis. Arch Intern Med. 1997;157:1864–1868.
  • Yazaki Y, Isobe M, Hiroe M, et al. Prognostic determinants of long-term survival in Japanese patients with cardiac sarcoidosis treated with prednisone. Am J Cardiol. 2001;88(Nov 1):1006–1010.
  • Kron J, Sauer W, Schuller J, et al. Efficacy and safety of implantable cardiac defibrillators for treatment of ventricular arrhythmias in patients with cardiac sarcoidosis. Europace. 2013;15(3):347–355.
  • Zhou Y, Lower EE, Li HP, et al. Cardiac sarcoidosis: the impact of age and implanted devices on survival. Chest. 2017;151(1):139–148.
  • Bradley DA, Lower EE, Baughman RP. Diagnosis and management of spinal cord sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2006;23(1):58–65.
  • Baughman RP, Grutters JC. New treatment strategies for pulmonary sarcoidosis: antimetabolites, biological drugs, and other treatment approaches. Lancet Respir Med. 2015;3(10):813–822.
  • Brozek JL, Akl EA, Alonso-Coello P, et al. Grading quality of evidence and strength of recommendations in clinical practice guidelines. Part 1 of 3. An overview of the GRADE approach and grading quality of evidence about interventions. Allergy. 2009;64(5):669–677.
  • Brozek JL, Akl EA, Compalati E, et al. Grading quality of evidence and strength of recommendations in clinical practice guidelines part 3 of 3. The GRADE approach to developing recommendations. Allergy. 2011;66(5):588–595.
  • Guyatt G, Oxman AD, Akl EA, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64(4):383–394.
  • Pietinalho A, Tukiainen P, Haahtela T, et al. Early treatment of stage II sarcoidosis improves 5-year pulmonary function. Chest. 2002;121:24–31.
  • Gibson GJ, Prescott RJ, Muers MF, et al. British thoracic society sarcoidosis study: effects of long term corticosteroid treatment. Thorax. 1996;51(3):238–247.
  • Gottlieb JE, Israel HL, Steiner RM, et al. Outcome in sarcoidosis. The relationship of relapse to corticosteroid therapy. Chest. 1997;111(3):623–631.
  • Schutt AC, Bullington WM, Judson MA. Pharmacotherapy for pulmonary sarcoidosis: a Delphi consensus study. Respir Med. 2010;104(5):717–723.
  • McKinzie BP, Bullington WM, Mazur JE, et al. Efficacy of short-course, low-dose corticosteroid therapy for acute pulmonary sarcoidosis exacerbations. Am J Med Sci. 2010;339(1):1–4.
  • Broos CE, Poell LHC, Looman CWN, et al. No evidence found for an association between prednisone dose and FVC change in newly-treated pulmonary sarcoidosis. Respir Med. 2018;138S:S31–S37.
  • Baughman RP, Judson MA, Teirstein A, et al. Presenting characteristics as predictors of duration of treatment in sarcoidosis. QJM. 2006;99(5):307–315.
  • Johns CJ, Michele TM. The clinical management of sarcoidosis: a 50-year experience at the Johns Hopkins hospital. Medicine. 1999;78:65–111.
  • Paramothayan NS, Lasserson TJ, Jones PW. Corticosteroids for pulmonary sarcoidosis. Cochrane Database Syst Rev. 2005;2:CD001114.
  • Khan NA, Donatelli CV, Tonelli AR, et al. Toxicity risk from glucocorticoids in sarcoidosis patients. Respir Med. 2017;132(SupplementC):9–14.
  • Baughman RP, Iannuzzi MC, Lower EE, et al. Use of fluticasone in acute symptomatic pulmonary sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2002;19(3):198–204.
  • Baughman RP, Winget DB, Lower EE. Methotrexate is steroid sparing in acute sarcoidosis: results of a double blind, randomized trial. Sarcoidosis Vasc Diffuse Lung Dis. 2000;17:60–66.
  • Muller-Quernheim J, Kienast K, Held M, et al. Treatment of chronic sarcoidosis with an azathioprine/prednisolone regimen. Eur Respir J. 1999;14(5):1117–1122.
  • Selroos O, Sellergren TL. Corticosteroid therapy of pulmonary sarcoidosis. Scand J Resp Dis. 1979;60:215–221.
  • Zaki MH, Lyons HA, Leilop L, et al. Corticosteroid therapy in sarcoidosis: a five year controlled follow-up. NY State J Med. 1987;87:496–499.
  • James DG, Carstairs LS, Trowell J, et al. Treatment of sarcoidosis: report of a controlled therapeutic trial. Lancet. 1967;2:526–528.
  • Israel HL, Fouts DW, Beggs RA. A controlled trial of prednisone treatment of sarcoidosis. Am Rev Respir Dis. 1973;107:609–614.
  • Hunninghake GW, Gilbert S, Pueringer R, et al. Outcome of the treatment for sarcoidosis. Am J Respir Crit Care Med. 1994;149(4 Pt 1):893–898.
  • Baughman RP, Meyer KC, Nathanson I, et al. Monitoring of nonsteroidal immunosuppressive drugs in patients with lung disease and lung transplant recipients: american college of chest physicians evidence-based clinical practice guidelines. Chest. 2012;142(5):e1S–e111S.
  • Vorselaars AD, Wuyts WA, Vorselaars VM, et al. Methotrexate versus azathioprine in second line therapy of sarcoidosis. Chest. 2013;144:805–812.
  • Vucinic VM. What is the future of methotrexate in sarcoidosis? A study and review. Curr Opin Pulm Med. 2002;8(5):470–476.
  • Lower EE, Baughman RP. Prolonged use of methotrexate for sarcoidosis. Arch Intern Med. 1995;155:846–851.
  • Goljan-Geremek A, Bednarek M, Franczuk M, et al. Methotrexate as a single agent for treating pulmonary sarcoidosis: a single centre real-life prospective study. Pneumonol Alergol Pol. 2014;82(6):518–533.
  • Isshiki T, Yamaguchi T, Yamada Y, et al. Usefulness of low-dose methotrexate monotherapy for treating sarcoidosis. Intern Med. 2013;52(24):2727–2732.
  • Morgan SL, Baggott JE, Vaughn WH, et al. Supplementation with folic acid during methotrexate therapy for rheumatoid arthritis. Ann Intern Med. 1994;121:833–841.
  • Cremers JP, Drent M, Bast A, et al. Multinational evidence-based World Association of Sarcoidosis and Other Granulomatous Disorders recommendations for the use of methotrexate in sarcoidosis: integrating systematic literature research and expert opinion of sarcoidologists worldwide. Curr Opin Pulm Med. 2013;19:545–561.
  • Kennedy PT, Zakaria N, Modawi SB, et al. Natural history of hepatic sarcoidosis and its response to treatment. Eur J Gastroenterol Hepatol. 2006;18(7):721–726.
  • Baughman RP, Koehler A, Bejarano PA, et al. Role of liver function tests in detecting methotrexate-induced liver damage in sarcoidosis. Arch Intern Med. 2003;163(5):615–620.
  • Roubille C, Haraoui B. Interstitial lung diseases induced or exacerbated by DMARDS and biologic agents in rheumatoid arthritis: a systematic literature review. Semin Arthritis Rheum. 2014;43(5):613–626.
  • Lewis SJ, Ainslie GM, Bateman ED. Efficacy of azathioprine as second-line treatment in pulmonary sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 1999;16:87–92.
  • Pacheo Y, Marechal C, Marechal F, et al. Azathioprine treatment of chronic pulmonary sarcoidosis. Sarcoidosis. 1985;2:107–113.
  • Hagaman JT, Kinder BW, Eckman MH. Thiopurine S-methyltranferase testing in idiopathic pulmonary fibrosis: a pharmacogenetic cost-effectiveness analysis. Lung. 2010;188(2):125–132.
  • Ertz-Archambault N, Kosiorek H, Taylor GE, et al. Association of therapy for autoimmune disease with myelodysplastic syndromes and acute myeloid leukemia. JAMA Oncol. 2017;3(7):936–943.
  • Kotlyar DS, Lewis JD, Beaugerie L, et al. Risk of lymphoma in patients with inflammatory bowel disease treated with azathioprine and 6-mercaptopurine: a meta-analysis. Clin Gastroenterol Hepatol. 2015;13(5):847–858.
  • Sahoo DH, Bandyopadhyay D, Xu M, et al. Effectiveness and safety of leflunomide for pulmonary and extrapulmonary sarcoidosis. Eur Respir J. 2011;38:1145–1150.
  • Baughman RP, Lower EE. Leflunomide for chronic sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2004;21:43–48.
  • Raj R, Nugent K. Leflunomide-induced interstitial lung disease (a systematic review). Sarcoidosis Vasc Diffuse Lung Dis. 2013;30(3):167–176.
  • Hamzeh N, Voelker A, Forssen A, et al. Efficacy of mycophenolate mofetil in sarcoidosis. Respir Med. 2014;108:1663–1669.
  • Brill AK, Ott SR, Geiser T. Effect and safety of mycophenolate mofetil in chronic pulmonary sarcoidosis: a retrospective study. Respiration. 2013;86:376–383.
  • Bitoun S, Bouvry D, Borie R, et al. Treatment of neurosarcoidosis: a comparative study of methotrexate and mycophenolate mofetil. Neurology. 2016;87(24):2517–2521.
  • Eisen HJ, Kobashigawa J, Keogh A, et al. Three-year results of a randomized, double-blind, controlled trial of mycophenolate mofetil versus azathioprine in cardiac transplant recipients. J Heart Lung Transplant. 2005;24(5):517–525.
  • Sweiss NJ, Noth I, Mirsaeidi M, et al. Efficacy results of a 52-week trial of adalimumab in the treatment of refractory sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2014;31(1):46–54.
  • Baughman RP. Tumor necrosis factor inhibition in treating sarcoidosis: the American experience. Revista Portuguesa De Pneumonologia. 2007;13:S47–S50.
  • Drent M, Cremers JP, Jansen TL, et al. Practical eminence and experience-based recommendations for use of TNF-alpha inhibitors in sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2014;31(2):91–107.
  • Sandborn WJ, Rutgeerts P, Enns R, et al. Adalimumab induction therapy for Crohn disease previously treated with infliximab: a randomized trial. Ann Intern Med. 2007;146(12):829–838.
  • Sandborn WJ, Hanauer SB, Rutgeerts P, et al. Adalimumab for maintenance treatment of Crohn’s disease: results of the CLASSIC II trial. Gut. 2007;56(9):1232–1239.
  • Judson MA, Baughman RP, Costabel U, et al. Safety and efficacy of ustekinumab or golimumab in patients with chronic sarcoidosis. Eur Respir J. 2014;44:1296–1307.
  • Utz JP, Limper AH, Kalra S, et al. Etanercept for the treatment of stage II and III progressive pulmonary sarcoidosis. Chest. 2003;124(1):177–185.
  • Baughman RP, Lower EE, Bradley DA, et al. Etanercept for refractory ocular sarcoidosis: results of a double-blind randomized trial. Chest. 2005;128(2):1062–1067.
  • Rossman MD, Newman LS, Baughman RP, et al. A double-blind, randomized, placebo-controlled trial of infliximab in patients with active pulmonary sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2006;23:201–208.
  • Baughman RP, Drent M, Kavuru MS, et al. Infliximab therapy in patients with chronic sarcoidosis and pulmonary involvement. Am J Respir Crit Care Med. 2006;174:795–802.
  • Sweiss NJ, Welsch MJ, Curran JJ, et al. Tumor necrosis factor inhibition as a novel treatment for refractory sarcoidosis. Arthritis Rheum. 2005;53(5):788–791.
  • Jamilloux Y, Cohen-Aubart F, Chapelon-Abric C, et al. Efficacy and safety of tumor necrosis factor antagonists in refractory sarcoidosis: A multicenter study of 132 patients. Semin Arthritis Rheum. 2017;47(2):288–294.
  • Doty JD, Mazur JE, Judson MA. Treatment of sarcoidosis with infliximab. Chest. 2005;127(3):1064–1071.
  • Baughman RP, Shipley R, Desai S, et al. Changes in chest roentgenogram of sarcoidosis patients during a clinical trial of infliximab therapy: comparison of different methods of evaluation. Chest. 2009;136:526–535.
  • Orum M, Hilberg O, Krag S, et al. Beneficial effect of infliximab on refractory sarcoidosis. Dan Med J. 2012;59(12):A4535.
  • Hostettler KE, Studler U, Tamm M, et al. Long-term treatment with infliximab in patients with sarcoidosis. Respiration. 2012;83(3):218–224.
  • Judson MA, Baughman RP, Costabel U, et al. The potential additional benefit of infliximab in patients with chronic pulmonary sarcoidosis already receiving corticosteroids: a retrospective analysis from a randomized clinical trial. Respir Med. 2014;108(1):189–194.
  • Sweiss NJ, Barnathan ES, Lo K, et al. C-reactive protein predicts response to infliximab in patients with chronic sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2010;27:49–56.
  • Vorselaars AD, Crommelin HA, Deneer VH, et al. Effectiveness of infliximab in refractory FDG PET positive sarcoidosis. Eur Respir J. 2015;46:175–185.
  • Russell E, Luk F, Manocha S, et al. Long term follow-up of infliximab efficacy in pulmonary and extra-pulmonary sarcoidosis refractory to conventional therapy. Semin Arthritis Rheum. 2013;43(1):119–124.
  • Panselinas E, Rodgers JK, Judson MA. Clinical outcomes in sarcoidosis after cessation of infliximab treatment. Respirology. 2009;14(4):522–528.
  • Vorselaars AD, Verwoerd A, Van Moorsel CH, et al. Prediction of relapse after discontinuation of infliximab therapy in severe sarcoidosis. Eur Respir J. 2014;43:602–609.
  • Milman N, Graudal N, Loft A, et al. Effect of the TNFalpha inhibitor adalimumab in patients with recalcitrant sarcoidosis: a prospective observational study using FDG-PET. Clin Respir J. 2012;6:238–247.
  • Crommelin HA, van der Burg LM, Vorselaars AD, et al. Efficacy of adalimumab in sarcoidosis patients who developed intolerance to infliximab. Respir Med. 2016;115:72–77. Epub;%2016 Apr 23.:72-77.
  • Minnis PA, Poland M, Keane MP, et al. Adalimumab for refractory pulmonary sarcoidosis. Ir J Med Sci. 2016;185(4):969–971.
  • Pariser RJ, Paul J, Hirano S, et al. A double-blind, randomized, placebo-controlled trial of adalimumab in the treatment of cutaneous sarcoidosis. J Am Acad Dermatol. 2013;68(5):765–773.
  • Keane J, Gershon S, Wise RP, et al. Tuberculosis associated with infliximab, a tumor necrosis factor-alpha neutralizing agent. N Engl J Med. 2001;345:1098–1104.
  • Reddy KR, Beavers KL, Hammond SP, et al. American Gastroenterological Association Institute guideline on the prevention and treatment of hepatitis B virus reactivation during immunosuppressive drug therapy. Gastroenterology. 2015;148(1):215–219.
  • Ramos-Casals M, Brito-Zeron P, Munoz S, et al. Autoimmune diseases induced by TNF-targeted therapies: analysis of 233 cases. Medicine (Baltimore). 2007;86(4):242–251.
  • Nanda KS, Cheifetz AS, Moss AC. Impact of antibodies to infliximab on clinical outcomes and serum infliximab levels in patients with inflammatory bowel disease (IBD): a meta-analysis. Am J Gastroenterol. 2013;108(1):40–47.
  • Baughman RP, Barney JB, O’hare L, et al. A retrospective pilot study examining the use of Acthar gel in sarcoidosis patients. Respir Med. 2016;110:66–72.
  • Baughman RP, Sweiss N, Keijsers R, et al. Repository corticotropin for Chronic Pulmonary Sarcoidosis. Lung. 2017;195:313–322.
  • Irwin RS, Manaker S, Metersky ML, et al. Higher priced older pharmaceuticals: how should we respond? Chest. 2017;17:10.
  • Wyser CP, Van Schalkwyk EM, Alheit B, et al. Treatment of progressive pulmonary sarcoidosis with cyclosporin A: a randomized controlled trial. Am J Respir Crit Care Med. 1997;156:1571–1576.
  • Tong Z, Dai H, Chen B, et al. Inhibition of cytokine release from alveolar macrophages in pulmonary sarcoidosis by pentoxifylline: comparison with dexamethasone. Chest. 2003;124(4):1526–1532.
  • Zabel P, Entzian P, Dalhoff K, et al. Pentoxifylline in treatment of sarcoidosis. Am J Respir Crit Care Med. 1997;155:1665–1669.
  • Park MK, Fontana JR, Babaali H, et al. Steroid sparing effects of pentoxifylline in pulmonary sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2009;26:121–131.
  • Baughman RP, Judson MA, Ingledue R, et al. The safety and efficacy of apremilast in chronic cutaneous sarcoidosis. Arch Dermatol. 2012;148:262–264.
  • Baltzan M, Mehta S, Kirkham TH, et al. Randomized trial of prolonged chloroquine therapy in advanced pulmonary sarcoidosis. Am J Respir Crit Care Med. 1999;160(1):192–197.
  • Krause ML, Cooper LT, Chareonthaitawee P, et al. Successful use of rituximab in refractory cardiac sarcoidosis. Rheumatology (Oxford). 2015;55:189–191.
  • Cinetto F, Compagno N, Scarpa R, et al. Rituximab in refractory sarcoidosis: a single centre experience. Clin Mol Allergy. 2015;13(1):19–0025.
  • Sweiss NJ, Lower EE, Mirsaeidi M, et al. Rituximab in the treatment of refractory pulmonary sarcoidosis. Eur Respir J. 2014;43(5):1525–1528.
  • Eishi Y, Suga M, Ishige I, et al. Quantitative analysis of mycobacterial and propionibacterial DNA in lymph nodes of Japanese and European patients with sarcoidosis. J Clin Microbiol. 2002;40(1):198–204.
  • Zhou Y, Wei YR, Zhang Y, et al. Real-time quantitative reverse transcription-polymerase chain reaction to detect propionibacterial ribosomal RNA in the lymph nodes of Chinese patients with sarcoidosis. Clin Exp Immunol. 2015;181:511–517.
  • Brownell I, Ramirez-Valle F, Sanchez M, et al. Evidence for mycobacteria in sarcoidosis. Am J Respir Cell Mol Biol. 2011;45(5):899–905.
  • Song Z, Marzilli L, Greenlee BM, et al. Mycobacterial catalase-peroxidase is a tissue antigen and target of the adaptive immune response in systemic sarcoidosis. J Exp Med. 2005;201(5):755–767.
  • Drake WP, Pei Z, Pride DT, et al. Molecular analysis of sarcoidosis tissues for mycobacterium species DNA. Emerg Infect Dis. 2002;8(11):1334–1341.
  • Jamilloux I, Valeyre D, Lortholary O, et al. The spectrum of opportunistic diseases complicating sarcoidosis. Autoimmun Rev. 2015;14(1):64–74.
  • Baughman RP, Lower EE. Fungal infections as a complication of therapy for sarcoidosis. QJM. 2005;98:451–456.
  • Dureault A, Chapelon C, Biard L, et al. Severe infections in sarcoidosis: incidence, predictors and long-term outcome in a cohort of 585 patients. Medicine (Baltimore). 2017;96(49):e8846.
  • Mathew S, Bauer KL, Fischoeder A, et al. The anergic state in sarcoidosis is associated with diminished dendritic cell function. J Immunol. 2008;181(1):746–755.
  • Lower EE, Smith JT, Martelo OJ, et al. The anemia of sarcoidosis. Sarcoidosis. 1988;5:51–55.
  • Ungprasert P, Crowson CS, Matteson EL. Sarcoidosis increases risk of hospitalized infection. a population-based study, 1976–2013. Ann Am Thorac Soc. 2017;14(5):676–681.
  • Leonhard SE, Fritz D, van de Beek D, et al. Cryptococcal meningitis complicating sarcoidosis. Medicine (Baltimore). 2016;95(35):e4587.
  • Kobak S, Yilmaz H, Sever F, et al. The prevalence of antinuclear antibodies in patients with sarcoidosis. Autoimmune Dis. 2014;2014:351852. Epub;%2014 Dec 17.:351852.
  • Weinberg I, Vasiliev L, Gotsman I. Anti-dsDNA antibodies in sarcoidosis. Semin Arthritis Rheum. 2000;29(5):328–331.
  • Baughman RP, Hurtubise P. Systemic immune response of patients with active pulmonary sarcoidosis. Clin Exp Immunol. 1985;61:535–541.
  • Hunninghake GW, Crystal RG. Mechanisms of hypergammaglobinemia in pulmonary sarcoidosis: site of increased antibody production and role of T-lymphocyte. J Clin Invest. 1981;67:86–96.
  • Atzeni F, Talotta R, Salaffi F, et al. Immunogenicity and autoimmunity during anti-TNF therapy. Autoimmun Rev. 2013;12(7):703–708.
  • Chimenti MS, Spinelli FR, Giunta A, et al. Emergence of antinuclear antibodies in psoriatic patients treated with infliximab: personal experience and literature review. Drug Dev Res. 2014;75(Suppl 1):S61–3.
  • Beigel F, Schnitzler F, Paul LR, et al. Formation of antinuclear and double-strand DNA antibodies and frequency of lupus-like syndrome in anti-TNF-alpha antibody-treated patients with inflammatory bowel disease. Inflamm Bowel Dis. 2011;17(1):91–98.
  • Vorselaars AD, Hijdra D, Van Moorsel CH, et al. Antinuclear antibodies do not predict anti-infliximab antibody induction in sarcoidosis. J Am Acad Dermatol. 2013;69(2):312–314.
  • Zhou Y, Lower EE, Li H, et al. Sarcoidosis patient with lupus pernio and infliximab-induced myositis: response to Acthar gel. Respir Med Case Rep. 2015;17:5–7.
  • Askling J, Grunewald J, Eklund A, et al. Increased risk for cancer following sarcoidosis. Am J Respir Crit Care Med. 1999;160(5 Pt 1):1668–1672.
  • Boffetta P, Rabkin CS, Gridley G. A cohort study of cancer among sarcoidosis patients. Int J Cancer. 2009;124(11):2697–2700.
  • Bonifazi M, Bravi F, Gasparini S, et al. Sarcoidosis and cancer risk: systematic review and meta-analysis of observational studies. Chest. 2015;147(3):778–791.
  • Bichari W, Bartiromo M, Mohey H, et al. Significant risk factors for occurrence of cancer after renal transplantation: a single center cohort study of 1265 cases. Transplant Proc. 2009;41(2):672–673.
  • Connell WR, Kamm MA, Dickson M, et al. Long-term neoplasia risk after azathioprine treatment in inflammatory bowel disease. Lancet. 1994;343(8908):1249–1252.
  • Khan N, Abbas AM, Lichtenstein GR, et al. Risk of lymphoma in patients with ulcerative colitis treated with thiopurines: a nationwide retrospective cohort study. Gastroenterology. 2013;145(5):1007–1015.
  • Wolfe F, Michaud K. Lymphoma in rheumatoid arthritis: the effect of methotrexate and anti-tumor necrosis factor therapy in 18,572 patients. Arthritis Rheum. 2004;50(6):1740–1751.
  • Wong AK, Kerkoutian S, Said J, et al. Risk of lymphoma in patients receiving antitumor necrosis factor therapy: a meta-analysis of published randomized controlled studies. Clin Rheumatol. 2012;31(4):631–636.
  • Lopez-Olivo MA, Tayar JH, Martinez-Lopez JA, et al. Risk of malignancies in patients with rheumatoid arthritis treated with biologic therapy: a meta-analysis. JAMA. 2012;308(9):898–908.

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