Long-term safety study of infliximab in moderate-to-severe chronic obstructive pulmonary disease

Stephen I. Rennard, Susan K. Flavin, Prasheen K. Agarwal, Kim Hung Lo, Elliot S. Barnathan

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Rationale: There was an increased number of malignancies in infliximab-treated (5.7%) over placebo-treated (1.3%) patients in a 44-week, phase 2 clinical study of 234 patients with moderate-to-severe chronic obstructive pulmonary disease (COPD). Objectives: To collect malignancy and mortality data from completed clinical studies of infliximab in COPD treatment. Methods: The multicenter, observational Remicade Safety Under Long-Term Study in COPD (RESULTS COPD) collected malignancy and mortality data every six months for five years from patients who received ≥1 study-agent dose in a phase 2 study. Co-primary endpoints were the number of patients with malignancy and the number of deaths. Secondary endpoints included the number of patients with a malignancy according to malignancy type. Results: There was a gap period between the end of the phase 2 study and the initiation of RESULTS COPD, during which six malignancies and 14 deaths were reported spontaneously for the 107 (45.7%) of 234 patients with long-term safety information. Twenty-eight patients (overall 12.0%; placebo 10.4%, infliximab 12.7%) reported malignancies, including 12 patients during RESULTS COPD. Twenty-six patients (overall 11.1%; placebo 9.1%, infliximab 12.1%) died, including nine during RESULTS COPD. Lung cancer was the most common malignancy type (placebo n = 2; infliximab n = 10). Conclusions: The greater proportion of malignancies observed with infliximab versus placebo in a phase 2 study diminished over the long-term follow-up. Due to the observational nature, limited patient participation, potential reporting bias from the interim spontaneous reporting period, and unblinding of all patients, more definitive conclusions cannot be drawn. Trial Registration Number: NCT00056264.

Original languageEnglish (US)
Pages (from-to)424-432
Number of pages9
JournalRespiratory Medicine
Volume107
Issue number3
DOIs
StatePublished - Mar 2013

Keywords

  • Anti-TNFα
  • COPD
  • Malignancy risk
  • Mortality risk

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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    Rennard, S. I., Flavin, S. K., Agarwal, P. K., Lo, K. H., & Barnathan, E. S. (2013). Long-term safety study of infliximab in moderate-to-severe chronic obstructive pulmonary disease. Respiratory Medicine, 107(3), 424-432. https://doi.org/10.1016/j.rmed.2012.11.008