Further reassurance over cancer risk with biologics

Treating rheumatoid arthritis with biologics does not lead to an increased risk of cancer or cancer recurrence, new data shows.

Presenting the findings of one of the studies here at this year’s EULAR congress here in Madrid Professor Johan Askling from the Karolinska Institute in Stockholm, Sweden, said the inhibition of TNF could ‘theoretically’ increase the risk of new or recurring cancers given it was one of the cytokines involved in the immunosurveillance of tumours.

“However, current guidelines do not provide clear guidance regarding the use of anti-TNF treatment in patients with recent malignancies,” he said during a press conference.

The study involved 446 patients with at least one diagnosis of solid cancer prior to the start of anti-TNF treatment.

They were compared with 1,278 matched controls with a history of equally recent cancer of the same type and stage who were not being prescribed biologic treatment.

Thirty (7%) of the RA patients treated with anti-TNFs  (7%) had a cancer that reoccurred (crude incidence rate 14/1000 person-years) compared with 89 (7%) among the 1,278 matched biologics-naive controls (crude incidence rate 17/1000 person-years).

The risk of cancer recurrence also did not seem to be influenced by the timing of treatment and the original cancer diagnosis.

“Rheumatologists should find our data reassuring. However, it is not possible to extrapolate these new findings to individuals with a very recent cancer, or a poor prognosis,” Professor Askling cautioned.

The findings only applied to the class of anti-TNF drugs and not necessarily to each individual anti-TNF drug, he added.

In another study presented at the same session Dr Hjalmar Wadström, also from the Karonlinska Institute, found no difference in the risk of developing a first cancer between RA patients started on tocilizumab, abatacept, rituximab, or a first- or second anti-TNF drug and RA patients treated with conventional synthetic DMARDs.

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