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Sun safety counseling lacking in rheumatoid arthritis patients on anti-TNF therapy
Patients with rheumatoid arthritis who received anti-tumor necrosis factor therapy were not properly counseled on protecting themselves from sun exposure, a study has reported.
One hundred fifty patients (mean age, 54.3 years; 60% women) who were on anti-tumor necrosis factor (TNF) therapy (mean length, 3.64 years) participated in a telephone survey in Ireland focusing on sun exposure and sunscreen usage. The cohort included those with rheumatoid arthritis (n=117), ankylosing spondylitis (n=18), psoriatic arthritis (n=14), and seronegative arthritis (n=1). Patients’ mean length of diagnosis was 11.22 years; 106 were taking methotrexate (MTX), a drug used in combination with anti-TNF therapy that doubled the risk for nonmelanoma skin cancer in RA patients, according to a previous study.
Seventy-three percent reported vacations to sunny destinations; 20% had a history of indoor tanning. Sixty-five percent used sunscreen, and 87% reported a history of previous sunburn. Five percent said they had been advised about sun exposure and sunscreen use.
Six percent of participants (mean age, 63 years) reported skin cancer diagnoses, despite using sunscreen, but said they had not received advice about sun exposure. Those patients had a 4-year history of anti-TNF therapy; 66% of those with skin cancer history used concurrent MTX.
“It is evident that patients do not receive adequate counseling on the importance of taking appropriate precautions when exposed to the sun,” the researchers concluded. “Only 5% of participants report having ever been advised on skin cancer prevention despite the fact that these patients may be at an increased risk of skin cancer.”
The researchers said conclusions were tentative, citing “these skin cancer diagnoses are self-reported and the true nature of the cancer history is not available to the researchers.”