患有恶性淋巴瘤（ML）和其他恶性肿瘤的类风湿性关节炎（RA）患者的背景状况和目前的治疗选择尚不清楚。本研究调查了 RA 患者中发生的 ML 和其他恶性肿瘤以及恶性肿瘤治疗后的背景因素之间的差异。我们从日本国家风湿病数据库中登记的 110,571 人年中确定了 935 名新发恶性肿瘤的 RA 患者。 2012 年至 2018 年。分析队列 1 和 2 分别包括 597 名和 490 名具有恶性肿瘤发生前和发生后 1 年可用数据的患者。通过多重逻辑回归分析对与 ML 发生相关的因素进行纵向评估。在 935 名患者中（平均年龄 70.5，标准差 9.9），15.5% 患有 ML；这与肺癌的发病率（14.3%）相当。在队列 1 中，74.4%、23.4% 和 56.7% 的 ML 以及 56.8% 的 ML 中使用了甲氨蝶呤 (MTX)、生物疾病缓解抗风湿药 (bDMARD) 和非甾体类抗炎药 (NSAID)。 、 25.4% 和 35.3% 在恶性肿瘤发生前 1 年发生其他恶性肿瘤。两组之间的临床疾病活动指数（CDAI）和C反应蛋白相似。多变量分析显示，MTX 使用（比值比 [OR]：2.22，95% CI [置信区间]：1.32-3.73，p=0.003）和 NSAID 使用（OR：2.51，95% CI：1.58-3.98，p <0.001） ）与 ML 的发展与其他恶性肿瘤显着相关。然而，bDMARD 并未观察到这种关联。在队列 2 中，发生恶性肿瘤一年后，MTX 未用于任何 ML 患者，而 41.8% 的患者发生其他恶性肿瘤。在两个恶性肿瘤组中，大约 15% 的患者接受 bDMARD，50% 的患者接受糖皮质激素。与其他恶性肿瘤患者相比，ML 患者优先使用 IL-6 抑制剂。第一年，ML 组和其他恶性肿瘤组的 CDAI 缓解率分别为 37.3% 和 31.1%。长期接受 MTX 和 NSAID 治疗的患者发生 ML 的风险可能相对较高。 ML 患者和其他恶性肿瘤患者发生恶性肿瘤后的治疗情况存在很大差异，应制定不同的治疗策略。版权所有 © 2023。由 Elsevier Inc. 出版。

The background status and the current treatment options of patients with rheumatoid arthritis (RA) who develop malignant lymphoma (ML) and other malignancies are unclear. This study investigated the differences in background factors between ML and other malignancies that occur in RA patients and post-malignancy treatment.We identified 935 RA patients with new-onset malignancies among 110,571 person-years registered in the National Database of Rheumatic Disease in Japan from 2012 to 2018. Analysis cohorts 1 and 2 included 597 and 490 patients with available data for 1 year before and after the development of malignancies, respectively. Factors associated with the development of ML were longitudinally evaluated by multiple logistic regression analyses.Of the 935 patients (mean age 70.5, standard deviation 9.9), 15.5% had ML; this was comparable to the rate of lung cancer (14.3%). In cohort 1, methotrexate (MTX), biological disease-modifying anti-rheumatic drugs (bDMARDs), and non-steroidal anti-inflammatory drugs (NSAIDs) were used in 74.4%, 23.4%, and 56.7% of ML and in 56.8%, 25.4%, and 35.3% of other malignancies 1 year before the occurrence of malignancies. Clinical disease activity index (CDAI) and C-reactive protein were similar between the two groups. Multivariable analysis showed that MTX use (odds ratio [OR]: 2.22, 95% CI [confidence interval]: 1.32-3.73, p=0.003) and NSAID use (OR: 2.51, 95% CI: 1.58-3.98, p <0.001) were significantly associated with the development of ML versus other malignancies. However, this association was not observed with bDMARDs. In cohort 2, one year after the development of malignancies, MTX was used in none of ML and 41.8% of patients who developed other malignancies. In both malignancy groups, approximately 15% of patients received bDMARDs and 50% received glucocorticoids. IL-6 inhibitors were preferentially prescribed in patients with ML versus those with other malignancies. At year 1, CDAI remission was achieved in 37.3% and 31.1% of patients in the ML and other malignancy groups, respectively.Patients receiving long-term treatment with MTX and NSAIDs may be at a relatively high risk of developing ML. The treatment landscape after developing malignancies differed considerably between patients with ML and other malignancies, and different treatment strategies should be established.Copyright © 2023. Published by Elsevier Inc.