Rheumatoid arthritis

Latest registry data confirms no elevated cancer risk with anti-TNFs

Tuesday, 30 May 2017

The latest analysis of data from the Australian Rheumatology Association Database (ARAD) and national cancer records confirms that any increased risk of cancer in rheumatoid arthritis patients is independent of their exposure to biologics.

The findings, presented at the joint meeting of the Australian Rheumatology Association and New Zealand Rheumatology Association, showed no difference between cancer risk in TNFi-exposed and biologic-naïve patients risk for any of the sites examined.

The research identified 107 cancers in 2,451 TNFi-exposed patients and 49 cancers in 574 biologic-naïve patients between 2012 and 2016.

Prof Rachelle Buchbinder, one of the ARAD principal investigators, told the limbic the news was reassuring for both patients and clinicians.

“The lack of any increased risk of malignancy among patients with rheumatoid arthritis who were exposed to TNFi compared to those who were biologic-naïve is consistent with our earlier findings.”

“TNF inhibitors do not appear to increase the risk of cancer above and beyond the background risk in patients with rheumatoid arthritis who have taken other disease-modifying drugs.”

However similar to their 2015 analysis [reported here in the limbic] there was some evidence of elevated risk for some malignancies in both treatment groups when compared with the general population.

Biologic-naïve patients showed an increased risk for lung (SIR 2.7) and prostate cancer (SIR 2.1) compared with the general population, while TNFi-exposed patients showed an increased risk for lung (SIR 1.7) and lymphoid cancer (SIR 1.8) compared with the general population.

The 2015 data identified an increased risk of melanoma in both biologic-naïve and biologic-exposed patients compared with the general population. However the current study found that while the estimates were increased (SIR 1.5 and 1.3 respectively), they no longer reached statistical significance.

“Compared with our previous study, we have larger numbers overall but comparatively fewer people who have never been exposed to biologics and still only a small number of cancers by site. Therefore some of our findings may be spurious and longer term monitoring is needed,” she said.

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