Biological treatments do not increase cancer risk in rheumatoid arthritis

This study investigated if there is an increased risk of cancer in rheumatoid arthritis patients taking immunomodulating drugs.

They found that there was no increased cancer risk in patients taking biological DMARDs compared to conventional synthetic DMARDs.

Rheumatoid arthritis (RA) is a chronic inflammatory condition that affects the joints. Standard drug treatment involves suppressing the immune system to reduce inflammation and pain. These drugs are called disease-modifying anti-rheumatic drugs or DMARDs.

There are several classes of DMARDs. The traditional, first line treatment are conventional, synthetic DMARDs (csDMARDs). Biological DMARDs are another type of immunomodulating drugs. Suppressing the immune system can also increase susceptibility to cancer. Little is know regarding whether bDMARDs may increase the risk of cancer in RA patients.

This study investigated the risk of cancer in RA patients taking bDMARDs.

This study included data from 21,487 patients treated with bDMARDs and 46,610 patients taking csDMARDs. bDMARDs administered included TNF inhibitors, such as tocilizumab (Actemra), abatacept (Orencia), and rituximab (Rituxan). Patient records were analyzed to assess the number of cancerous tumors and any events of melanoma or squamous cell skin cancer.

Patients receiving bDMARDs did not have an increased risk of solid cancer tumors or melanoma compared to csDMARDs. Abatacept was associated with an increased risk of squamous cell skin cancer when administered as the first treatment.

This study concluded that there is no increased cancer risk in patients taking biological DMARDs compared to conventional synthetic DMARDs.

The finding of an association between abatacept and squamous cell skin cancer is the first report of this. Further studies needed to confirm the association. Not all cancers were included in the analysis.

If you have any concerns regarding the safety of DMARDs, please discuss with your physician.