Studies Confirm Biologic DMARDs Do Not Increase Cancer Risk

Two studies presented at the 2017 EULAR Congress confirmed that biologic disease- modifying anti-rheumatic drugs (DMARDs), including anti-TNF treatments, do not increase the risk of cancer in patients with RA.

Previous data have shown that use of DMARDs have not increased cancer risk in RA patients. Despite this, current guidelines caution against their use in patients with a previous diagnosis of cancer within 5 to 10 years. 

In order to study the added cancer risk, the researchers matched a cohort of 446 RA patients with a past diagnosis of nonskin cancer who were prescribed DMARDs to a control cohort of 1278 RA patients with a past cancer diagnosis who were not prescribed DMARDs.

The results of the study showed that 7% of the DMARDs cohort had a reoccurring diagnosis of cancer compared with 7% of the control group. The researchers confirmed through statistical demographic analysis that there was no increased risk of cancer for any cancer type, aside from uterine cancer. However, the researchers said that the high hazard ratio (14.8) for uterine cancer was based on a single event in the anti-TNF group.

The researchers noted that these data do not draw a clear conclusion for patients with a very recent cancer or poor prognosis. 

“Because TNF is one of the cytokines involved in the immunosurveillance of tumors, its inhibition may theoretically increase the risk of new tumor formation or cancer recurrence,” Johan Askling, MD, PhD, from Karolinska Institute in Sweden, said in a press release. “However, current guidelines do not provide clear guidance regarding the use of anti-TNF treatment in patients with recent malignancies. Rheumatologists should find our data reassuring. However, it is not possible to extrapolate these new findings to individuals with a very recent cancer, or a poor
prognosis.”—David Costill