04 Jun Icahn Mt Sinai Study Finds Immunosuppressives Not Likely To Increase Cancer Risk in Inflammatory Bowel Disease Patients
MedicalResearch.com Interview with:
Dr. Itzkowitz
Steven H. Itzkowitz, MD, FACP, FACG, AGAF
Professor of Medicine and Oncological Sciences
Director of the GI Fellowship Program
Icahn School of Medicine at Mount Sinai
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This study looked at patients with inflammatory bowel disease (IBD) who had a history of cancer in the past 5 years and asked whether the medications they received for their IBD might have affected their rates of getting future cancer (new or recurrent cancers). Because many of the medicines that are used to treat IBD can affect the immune system in various ways, there has been concern that the medicines might predispose to subsequent cancers.
We found that patients who received immunosuppressive medications had a numerically increased risk of subsequent cancer, this was not statistically higher than those who had not been exposed to these medications. While previous studies have looked at this question retrospectively, this is the first report that analyzed this issue prospectively using individuals from the United States. Moreover, this study represents a multi-institutional collaboration among gastroenterologists at most of the major NYC healthcare systems.
MedicalResearch.com: Do the immunosuppressive therapies in the study include long term steroids?
Response: No. We did not include steroids as immunosuppressive therapy for the purpose of this study. Although steroids do suppress the immune system, the purpose was to report on the new IBD drugs (anti-TNF, anti-integrin, anti-IL12/23, JAK inhibitors and sphingosine 1-phosphate receptor modulators.
MedicalResearch.com: What should readers take away from your report?
Response: Patients with IBD and a history of cancer (and their healthcare providers) can feel somewhat more reassured that taking these very effective IBD medications is not likely to promote the development of future cancers any more so than patients with IBD who have not taken these medications.
MedicalResearch.com: What recommendations do you have for future research as a results of this study?
Response: Patients with IBD who are on IBD medications should continue to be followed closely for the development of incident cancer. The SAPPHIRE Registry will continue to enroll patients and follow them prospectively, in this regard. In addition, more research is needed about patients with IBD who have active cancer, and how best to manage both their IBD treatment and cancer treatment.
I have no relevant disclosures.
Citation: Itzkowitz SH, Jiang Y, Villagra C, Colombel JF, Sultan K, Lukin DJ, Faleck DM, Scherl E, Chang S, Chen L, Katz S, Kwah J, Swaminath A, Petralia F, Sharpless V, Sachar D, Jandorf L, Axelrad JE; New York Crohn’s and Colitis Organization. Safety of Immunosuppression in A Prospective Cohort of Inflammatory Bowel Disease Patients with a HIstoRy of CancEr: SAPPHIRE Registry. Clin Gastroenterol Hepatol. 2024 May 18:S1542-3565(24)00479-8. doi: 10.1016/j.cgh.2024.05.006. Epub ahead of print. PMID: 38768673.
https://pubmed.ncbi.nlm.nih.gov/38768673/
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Last Updated on June 4, 2024 by Marie Benz MD FAAD