Study explores malignant neoplasm risk among patients with RA treated with bDMARDs

There was no substantial difference in the overall risk of cancer among patients with rheumatoid arthritis treated with tumor necrosis factor inhibitors as the first or second biological disease-modifying antirheumatic drugs, tocilizumab, abatacept or rituximab and those who were biologic drug-naïve and treated with disease-modifying antirheumatic drugs or conventional synthetic disease-modifying antirheumatic drugs, according to study results.

Researchers performed a national registry-based prospective cohort study in Sweden from 2006 to 2015 of patients with rheumatoid arthritis treated with tocilizumab, abatacept, rituximab or tumor necrosis factor inhibitors (TNFi) as first-ever or second-ever biological disease-modifying antirheumatic drugs (bDMARDs) or conventional synthetic DMARDs. The study also included a general population cohort. First-invasive, solid malignant neoplasm, hematologic malignant neoplasm or skin cancer were primary outcomes.

Results showed the number of events for the first invasive solid or hematologic malignant neoplasm for tocilizumab, abatacept, rituximab, initiators of TNFi as first bDMARD and TNFi as second bDMARD were 50, 61, 141, 478 and 169, respectively. Investigators noted there were no statistically significant differences in outcomes for treatment with tocilizumab, abatacept or rituximab, except for an increased chance for squamous cell skin cancer when the initiators of abatacept were compared with the initiators of either first TNFi or second TNFi. – by Monica Jaramillo

Disclosures: The study was funded by the Swedish Cancer Society, the Swedish Foundation for Strategic Research, the Stockholm County Council and the Swedish Research Council. Please see the full study for a list of all other authors’ relevant financial disclosures.

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Source:

Wadström H, et al. JAMA Intern Med. 2017;doi:10.1001/jamainternmed.2017.4332.