Biologics do not increase the risk of second cancer diagnosis in people with rheumatoid arthritis, says new research

Treatment with biologics does not seem to increase the risk of a second malignancy in people with rheumatoid arthritis who have a history of cancer, researchers reveal at an international conference.

There have been concerns that biologics, which suppress the immune system, could increase the risk of malignancy in people with a history of cancer. Now a team of researchers in Denmark have looked at people with rheumatoid arthritis to see if biologic use increased the risk of a second cancer diagnosis.

Of the 1,678 people with rheumatoid arthritis:

• 190 received biologics before their first cancer diagnosis;
• 220 received biologics only after their first cancer diagnosis;
• 92 received biologics both before and after their first cancer diagnosis;
• 1,176 never received biologics.

Findings

Of the 502 people who received a biologic at any time, the chance of developing a second cancer was not statistically significant. No clear conclusion could be made about increase in mortality rates but there seemed to be no “major indication of an increased mortality rate among users of these medications”.

But the overall number of people who experienced a second cancer was small so further studies are needed to confirm the findings.

“In the meantime, our data does provide some reassurance that biologics don’t pose an immediate danger in patients with a history of cancer,” concludes lead author, Dr Lene Dreyer. “Second malignancy is an increasing challenge, as the survival after the first, primary tumor has improved substantially for most types of cancer. The concern for second malignancy or cancer recurrences in patients with a history of cancer diagnosis has led to some reluctance in treating this subset of arthritis patients with biologics, especially TNF-inhibitors. Consequently, some rheumatoid arthritis patients with a previous cancer are suffering from inadequate treatment of their arthritis.”

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