PT  - JOURNAL ARTICLE
AU  - Kedra, Joanna
AU  - Seror, Raphaele
AU  - Dieudé, Philippe
AU  - Constantin, Arnaud
AU  - Toussirot, Eric
AU  - Kfoury, Elias
AU  - Masson, Charles
AU  - Cornec, Divi
AU  - Dubost, Jean Jacques
AU  - Marguerie, Laurent
AU  - Ottaviani, Sebastien
AU  - Grados, Franck
AU  - Belkhir, Rakiba
AU  - Fain, Olivier
AU  - Goupille, Philippe
AU  - Sordet, Christelle
AU  - Fautrel, Bruno
AU  - Philippe, Peggy
AU  - Piperno, Muriel
AU  - Combe, Bernard
AU  - Lambotte, Olivier
AU  - Richez, Christophe
AU  - Sellam, Jérémie
AU  - Sené, Thomas
AU  - Denis, Guillaume
AU  - Lequerre, Thierry
AU  - Lazure, Thierry
AU  - Mariette, Xavier
AU  - Nocturne, Gaetane
TI  - Lymphoma complicating rheumatoid arthritis: results from a French case–control study
AID  - 10.1136/rmdopen-2021-001698
DP  - 2021 Sep 01
TA  - RMD Open
PG  - e001698
VI  - 7
IP  - 3
4099  - http://rmdopen.bmj.com/content/7/3/e001698.short
4100  - http://rmdopen.bmj.com/content/7/3/e001698.full
SO  - RMD Open2021 Sep 01; 7
AB  - Objectives To study the characteristics of B-cell non-Hodgkin’s lymphoma (NHL) or Hodgkin lymphoma complicating rheumatoid arthritis (RA) and to identify RA-related factors associated with their occurrence.Methods A multicentre case–control study was performed in France. Cases were patients with RA fulfilling ACR-EULAR 2010 criteria in whom B-cell NHL or Hodgkin lymphoma developed after the diagnosis of RA. For each case, 2 controls were assigned at random from the ESPOIR cohort and were matched on age at lymphoma diagnosis (cases)/age at the 10-year follow-up visit in the cohort (controls). Case and control characteristics were compared to identify parameters associated with the occurrence of lymphoma.Results 54 cases were included and matched to 108 controls. Lymphomas were mostly diffuse large B-cell lymphoma (DLBCL, n=27, 50.0%). On immunochemistry, 4 of 27 (14.8%) lymphoma cases were positive for Epstein-Barr virus. On univariate analysis, factors associated with the occurrence of lymphoma were male sex (OR 3.3, 95% CI 1.7 to 6.7), positivity for ACPA (OR 5.1, 95% CI 2.0 to 15.7) and rheumatoid factor (OR 3.9, 95% CI 1.6 to 12.2), and erosions on radiographs (OR 3.8, 95% CI 1.7 to 8.3) and DAS28 (OR 2.0, 95% CI 1.5 to 2.7), both at the time of matching. Methotrexate, TNF blockers and a number of previous biologics were not associated with the occurrence of lymphoma. On multivariable analysis, erosions and DAS28 remained significantly associated with increased risk of lymphoma.Conclusion Lymphomas complicating RA are mostly DLBCL. Risk of lymphoma in patients with RA was increased with markers of disease activity and severity, which supports the paradigm of a continuum between autoimmunity and lymphomagenesis in RA.All data relevant to the study are included in the article or uploaded as supplementary information.