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Table 1 General characteristics of the studies

From: Risk of non-melanoma skin cancer with biological therapy in common inflammatory diseases: a systemic review and meta-analysis

Study Country Data source Study period Biologic treatment group   None-biologic treatment group   Risk estimate (95%CI) Adjustment
Biologic drugs Number/ cases Age (years) Female (%) Mean/median treatment duration (years) Control Number/cases Age (years) Female (%) Mean/median treatment duration (years)
RA
Dreyer 2013 Denmark The national Danish DANBIO database 2000–2008 TNFI 3347/42 54.3 73 2.9 Nonbiologic DMARDS 3812/34 61.2 74 2.1 HR,1.10 (0.69–1.76) Age,gender,calendar time
Wadström 2017 Sweden The Swedish Rheumatology Quality of Care Register 2006–2015 TNFI 10,760/54 58 74 NR Conventional systemic DMARDS 46,416/467 64 71 NR SCC HR,1.09 (0.84–1.42) Age, gender, start of treatment year, comorbidities, No. of hospitalizations, educational level, days spent in inpatient care
Abatacept 2016/17 61 80 SCC HR,2.15 (1.31–3.52)
Rituximab 3566/24 63 76 SCC HR,1.01 (0.66–1.55)
Tocilizumab 1788/5 59 78 SCC HR,0.93 (0.39–2.21)
Wolfe 2007 USA US National Data Bank for Rheumatic Diseases 1998–2005 Infliximab 4430/161 58.5 78 2.9 Biologic naïve NR 58.5 78 NR OR,1.7 (1.3–2.2) Age, gender, educational level, smoking history, baseline patient activity scale, baseline prednisone use
Etanercept 3163/126 2.7 OR,1.2 (1.0–1.5)
Adalimumab 812/10 1.2 OR,0.9 (0.5–1.8)
Ozen 2019 USA US National Data Bank for Rheumatic Diseases 2005–2015 Abatacept 1099/37 61.5 85.5 2.5 Conventional systemic DMARDS 1103/20 63.3 80.9 2 HR,1.05 (0.22- 4.98) Age, gender, employment status, annual income, education level, smoking status, disease duration, HAQ-Disability Index, pain and patient global scores, BMI, Rheumatic Diseases Comorbidity Index score, any chronic lung disease, diabetes, number of prior bDMARDs, glucocorticoid use, year of study entry, follow-up time
Solomon 2014 USA Corrona RA registry 2001–2010 TNFI 3761/22 NR 77.7 NR Methotrexate 1566/17 NR 72.3 NR HR,0.57 (0.26–1.27) Age, gender, race, tobacco, alcohol use, BMI, disease duration, serologic status, joint erosions, CDAI, family history of cancer, HAQ, number of past DMARDs used, use of oral glucocorticoids
Abatacept 408/5 NR 84.1 HR,1.85 (0.33–10.43)
Rituximab 167/1 NR 76.7 HR,1.61 (0.09–28.6)
Amari 2011 USA The Austin Information Technology Center and the pharmacy benefits management 1998–2008 TNFI 4088/283 59.6 9.6 NR Nonbiologic DMARDS 18,396/1043 63.1 9.4 NR HR,1.42 (1.24–1.63) Age, gender, race, comorbid diagnoses
Raaschou 2016 Sweden The Swedish Biologics Register 1998–2012 BCC TNFI 8827/236 55.3 74.8 4.2 BCC Biologic naïve 43,675/1587 61.6 71.5 4.7 HR,1.14 (0.98–1.33) Age, gender, birth year, country of birth, county of residency, educational level, comorbidities until start of follow-up (hospital admissions/outpatient visits for chronic obstructive pulmonary disease, ischemic heart disease, diabetes mellitus, knee/hip joint replacement surgery, psoriatic disease)
SCC TNFI 12,558/191 55.2 75.4 5.9 SCC Biologic naïve 46,409/847 60.9 71.5 5.1 HR,1.30 (1.10–1.55)
Mercer 2017 UK British Society for Rheumatology Biologics Register 2003–2008 TNFI 11,704/BCC 150, SCC 23 56 76 4.01 Nonbiologic DMARDS 3523/BCC 38, SCC 4 60 72 2.65 BCC HR,1.20 (0.83 to 1.73)
SCC HR,1.79 (0.59 to 5.41)
Age,gender
Etanercept 5086/BCC 57 56 77 3.7 BCC,HR,1.07 (0.70 to 1.63)
Infliximab 3663/BCC 59 56 76 2.7 BCC,HR,1.73 (1.14 to 2.62)
Adalimumab 5035/BCC 34 57 76 2.05 BCC,HR,0.89 (0.56 to 1.42)
Haynes 2012 USA Safety Assessment of Biological Therapeutics 1998–2007 TNFI 19,750/134 NR 85.1 0.5 Methotrexate 9805/77 NR 85.8 0.3 HR,1.07 (0.79–1.46) Propensity scores calculated according to age, sex, race, residence, nursing home/community dwelling, area income, calendar year, number of hospitalizations, outpatient and emergency room visits, number of different medication classes filled, extraarticular disease manifestations, number of intraarticular and orthopedic procedures, number of laboratory tests ordered for inflammatory markers, chronic obstructive pulmonary disease, diabetes, and use of cancer screening tests
IBD
Haynes 2012 USA Safety Assessment of Biological Therapeutics 1998–2007 TNFI 2657/14 NR 66.9 NR Azathioprine or mercaptopurine 3700/30 NR 65.9 NR HR,0.37 (0.13–1.07) Propensity scores calculated according to age, sex, race, residence, nursing home/community dwelling, area income, calendar year, number of hospitalizations, outpatient and emergency room visits, number of different medication classes filled, extraarticular disease manifestations, number of intraarticular and orthopedic procedures, number of laboratory tests ordered for inflammatory markers, chronic obstructive pulmonary disease, diabetes, and use of cancer screening tests
Long 2010 USA PharMetrics Patient-
Centric Database
1996–2005 Adalimumab or Infliximab-recent use 387/14 49.7 47.6 NR None 1548/36 49.2 47.6 NR CD,HR,2.47 (1.29–4.73) Age, gender, geographic region, and duration of follow-up
Adalimumab or Infliximab-persist use 228/7 913/13 CD,HR,3.23 (1.24–8.45)
Psoriasis
Asgari 2017 USA Kaiser Permanente Northern California health insurance database 1998–2011 Biologics (including adalimumab, etanercept, infliximab, certolizumab, ustekinumab, golimumab, tocilizumab, abatacept, anakinra, and rituximab) 2285/109 47.6 47 5.86 Nonbiologic therapy 3604/251 53.1 51 5.23 NMSC HR, 1.42 (1.12–1.80)
BCC HR, 1.81 (1.23–2.67)
SCC HR,1.23 (0.91–1.66)
Age, gender, race/ethnicity, presence of psoriatic arthritis; prior UV light therapy, BMI, and cigarette use
Kimball 2015 USA MarketScan commercial and Medicare Supplemental claims database 1995–2011 Etanercept 6856/316 49 45.4 NR Nonbiologic therapy 5857/353 53 55.9 NR RR, 1.1 (0.8–1.6) Age, gender, systemic medication exposure at baseline
Adalimumab 3314/175 49 47.4 RR, 1.2 (0.7–1.9)
Infliximab 1044/51 49 53.5 RR, 1.1 (0.4–2.5)
Haynes 2012 USA Safety Assessment of Biological Therapeutics 1998–2007 TNFI 563/ < 5 NR 65.2 NR Methotrexate 735/6 NR 59.6 NR HR,0.35 (0.04–3.43) Propensity scores calculated according to age, sex, race, residence, nursing home/community dwelling, area income, calendar year, number of hospitalizations, outpatient and emergency room visits, number of different medication classes filled, extraarticular disease manifestations, number of intraarticular and orthopedic procedures, number of laboratory tests ordered for inflammatory markers, chronic obstructive pulmonary disease, diabetes, and use of cancer screening tests
  1. DMARDs: disease-modifying anti-rheumatic drugs; mHAQ: modified Health Assessment Questionnaire; COPD: chronic obstructive pulmonary disease; BMI: body mass index; CDAI: Clinical Disease Activity Index; CRP: C-reactive protein; DAS28: disease activity score in 28 joints; RDCI: Rheumatic Disease Comorbidity Index score; NR: Not reported