Taking certain biologics or disease-modifying anti-rheumatic drugs may be associated with a risk of cancer

1. The use of rituximab, abatacept, and Janus kinase inhibitors (JAKis) in individuals with rheumatoid arthritis (RA) was associated with a statistically significant increased risk of cancer compared to the use of tumor necrosis factor inhibitors (TNFis).

Evidence rating level: 2 (Good)

In recent years, safety concerns have been raised regarding the continued use of JAKis in patients with RA, as one study reported a higher incidence of cancer associated with the use of tofacitinib compared to TNFis. Similar studies have since been conducted, but their applicability to patients in the United States is limited. Therefore, this retrospective cohort study aimed to examine the comparative safety of TNFis, non-TNFis, and JAKis in RA patients living in the United States. Between November 2012 and December 2021, patients aged 18 to 64 years with RA were identified using the Merative Marketscan Research Databases. The primary outcome of interest was any incident cancer attributable to recent exposure to biologic or synthetic DMARDs. A total of 25,305 patients (median age (IQR) 50 (42–56) years; 79% female) were included in the study. Rituximab exposure was associated with the highest incidence rate of all cancers compared to all other groups (171 (95% CI: 94-285) cancer diagnoses per 10,000 person-years), while TNFis were associated with the lowest incidence rate (78 (95% CI , 66-91) diagnoses per 10,000 person-years). Based on multivariate Cox proportional hazards regression analysis, rituximab was associated with a higher risk of cancer compared with TNFis (HR 1.91; 95% CI 1.17-3.14), followed by abatacept (HR 1, 47; 95% CI 1.03–2.11) and JAKis (HR 1.36; 95% CI, 0.94-1.96). Overall, this study found that the use of rituximab, abatacept, and JAKis in RA patients living in the United States was associated with an increased risk of cancer compared to the use of TNFis.

Click here to read the study in JAMA Network Open

Image: PD

©2024 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without the express written consent of 2 Minute Medicine, Inc. Inquire about licensing Here. No article should be construed as medical advice and is not intended as such by the authors or 2 Minute Medicine, Inc.