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Malignancies rare following anti-TNF-a therapy; most patients discontinue biologics

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A small number of patients developed a malignancy while receiving anti-tumor necrosis factor-alpha treatment for an autoimmune disease, and most who did discontinued treatment with biologic agents, according to the results of a study.

Researchers identified 950 patients who received anti-tumor necrosis factor-alpha (TNF-a) treatment, of whom, 27 (2.8%) were concurrently diagnosed with a malignancy. Seventeen (63%) were women, 15 (56%) had a solid malignancy, five (15%) had skin cancers and the rest had leukemia or lymphoid malignancies. Of the solid malignancies, lung carcinoma was reported in four cases (26%), and three malignancies (20%) were breast carcinoma.

Rheumatoid arthritis was the condition being treated with biologic therapy in 59% of the patients who developed a malignancy. Patients with ankylosing spondylitis accounted for 15% of the patients who developed malignancies, and patients with psoriatic arthritis comprised 26% of the malignancy cases.

Following the diagnosis of the malignancy, 63% of patients discontinued biologic therapy within 1 month of diagnosis, on average. Reasons cited included patient choice, ongoing treatment of the malignancy or the lack of information available for an alternate biologic for a disease such as ankylosing spondylitis.

More than half of the patients (55%) received Humira (adalimumab, AbbVie), 26% received Enbrel (etanercept, Amgen) and the remainder received Remicade (infliximab, Janssen) or Simponi (golimumab, Janssen). All of the patients who were diagnosed with lung cancer were smokers. The mortality rate from widespread metastases among the patients with malignancies was 19%, according to the researchers. – by Shirley Pulawski

Reference:

Uppal S, et al. Paper #AB1207. Presented at: European League Against Rheumatism Annual European Congress of Rheumatology; June 10-13, 2015; Rome.

Disclosure: The researchers report no relevant financial disclosures.