Pos1383 Risk of Cancers According to the Use of Biological Agents in Patients With Ankylosing Spondylitis: A Nationwide Population-Based Cohort Study

Background: As the duration of use of biological disease-modifying anti-rheumatic drugs (bDMARDs) in patients with ankylosing spondylitis (AS) accumulates over time, long-term real-world safety data on cancer risk are needed. Objectives: This study assessed the association between tumor necrosis factor inhibitors (TNFis) and interleukin-17 inhibitors (IL-17is) exposures and cancer risk in patients with AS. Methods: From the Korean nationwide database, we assembled 41,889 patients without prior history of cancer who were diagnosed with AS from 2010 onwards. Patients were followed-up through 2021. Multivariable time-dependent Cox models were performed to estimate the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of (i) overall cancers and (ii) cancer subtypes according to TNFis exposure vs. bDMARDs non-exposure, IL-17is exposure vs. bDMARDs non-exposure, and IL-17is exposure vs. TNFis exposure. Results: The incident rates of overall cancers during bDMARDs non-exposure, TNFis exposure, and IL-17is exposure were 53.81, 37.63, and 67.27 per 10,000 person-years, respectively. TNFis exposure vs. bDMARDs non-exposure was not associated with an increased risk of overall cancers (aHR=0.919, 95% CI=0.775–1.090). IL-17is exposure was not associated with an increased risk of overall cancers compared with bDMARDs non-exposure (aHR=1.233, 95% CI=0.510–2.984) or TNFis exposure (aHR=1.342, 95% CI=0.551–3.272). Similarly, no significant associations were observed between exposure to bDMARDs with the risk of cancer subtypes. Conclusion: In patients with AS, there was no evidence of increased cancer risk with TNFis and IL-17is exposures compared with bDMARDs non-exposure, suggesting that the use of bDMARDs is safe with respect to cancer risk in patients with AS. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.