Background/Purpose: To compare the risk of solid cancer in patient with rheumatoid arthritis treated with biologic disease modifying antirheumatic drugs(b-DMARDs) to that in patients treated with non-biologic (synthetic) DMARDs (sDMARDs) with/without prior cancers.

Methods: 2190 RA patients were enrolled in our rheumatology clinic. Patients were diagnosed according to ACR/EULAR 2010 classification criteria, and treated with DMARDs. Rate of solid cancers were retrospectively examined.

Results:

2175 RA patients without prior cancers were enrolled to this study. Rates of solid cancers in 1897 patients without prior cancers who received sDMARDs(M/F=1671/226, age=60.5+/-14.2) were compared to those in 278 patients without prior cancers who received bDMARDs(M/F=252/26, age=58.7+/-12.5).50 patients developed a new solid cancer which include 6 gastric cancers, 6 colon cancers, 3 lung cancers, 14 breast cancers and 21 other cancers. The rates of incident solid cancer were 2.33 events/1000person-years in sDMARDs cohort, 1.59 events/1000person-years in bDMARDs cohort and 2.08 events/1000person-years inTNFi cohort. There was no difference in risk of solid cancer for bDMARDs and TNFi compared to sDMARDs treated patients. There was no difference in the relative risk of cancer for any of the individual TNFi therapy.

Secondary we investigate the recurrence of the solid cancers in 15 patients with RA and a history of solid cancer before start of DMARDs. The 0.7% of patients in the sDMARDs cohort had a recurrence of the same cancer in comparison with the 0.4% and the 0.9% in the bDMARDs and TNFi cohorts, respectively.

Conclusion:

The addition of bDMARDs to sDMARDs does not alter the risk of solid cancer in RA patients without prior cancers in this study. Although patient numbers are still low, it seems that RA patients with prior cancer received bDMARDs do not have an increased risk of recurrence of same solid cancers.

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-risk-of-solid-cancers-in-patients-with-rheumatoid-arthritis-exposed-to-biologic-dmards-with-without-prior-cancers/