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Few topics in rheumatology have reshaped prescribing behaviour as dramatically as the safety concerns surrounding JAK inhibitors following ORAL Surveillance and the subsequent FDA and EMA warnings.
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Dr. Jack Cush reviews the news, journal articles and missed quiz questions.
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A current article in Nature Reviews Rheumatology has a patient boldly asking why we rheumatologists aren't more like her oncologists?
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Malignancy rivals cardiovascular disease as a leading cause of death in patients with systemic autoimmune diseases. Chronic inflammation and immune dysregulation can drive oncogenesis, while antitumor immune responses can trigger autoimmune phenomena (paraneoplastic syndromes, checkpoint inhibitor-induced rheumatic disease).
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A retrospective target trial emulations has shown that low-dose aspirin (ASA) given with a giant cell arteritis (GCA) diagnosis is associated with a lower risk of major adverse cardiovascular events (MACE), but a higher risk of GI bleeding.
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An Italian retrospective study of 411 idiopathic inflammatory myopathies (IIM) patients applied IMACS criteria to assess the risk of cancer and found significantly more cancers in those at high risk.
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Dr. Jack Cush reviews the news and journal reports from RheumNow.com this week - including his top four favorite subjects.
Nelly ZIADE 🍀
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🎗️ Do targeted therapies raise cancer risk in SpA?
French nationwide cohort (n=56,591): NO
In fact, prolonged exposure REDUCES risk (wHR 0.86), especially haematological.
#OP0238 #EULAR2026 @RheumNow https://t.co/dDveAmWpdX
Mrinalini Dey
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#OP0238: French SNDS cohort found longer exposure to targeted therapies in SpA (>6months) was assoc with a lower overall cancer risk vs shorter exposure, esp for haematologic malignancies. Data add to long-term safety evidence for targeted therapies in SpA. #EULAR2026 @RheumNow
Mrinalini Dey
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#OP0225 at #EULAR2026: In this nationwide French cohort, patients with IMIDs had nearly 2x risk of HPV-related cancers or severe dysplasia versus matched controls. Risk was particularly increased in SLE, reinforcing the importance of HPV vaccination and screening. @RheumNow
Mrinalini Dey
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#OP090 at #EULAR2026: In this nationwide Danish study, RA patients with lung cancer had similar survival outcomes to patients without RA. Importantly, immune checkpoint inhibitor treatment did not appear to worsen outcomes in patients with pre-existing RA. @RheumNow
Mrinalini Dey
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#OP087 explored cancer polygenic risk scores (PRS) in RA. RA was assoc with lower risks of breast and colorectal cancer across all PRS categories, while high prostate cancer PRS may identify RA patients with increased early prostate cancer diagnoses. @RheumNow #EULAR2026 https://t.co/WMqqSFADlW
Mrinalini Dey
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Cancer risk with JAK inhibitors remains a major focus at #EULAR2026. In #OP086, analysis from 14 international RA registries and >60000 treatment courses found no statistically significant increase in overall or subtype-specific malignancy risk with JAKi versus TNFi. @RheumNow https://t.co/JeOmTufYwo
Dr. John Cush
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Veterans Administration study of 301 #RA pts Rx w/ immune checkpoint inhibitor (ICI) for cancer shows all cause mortality in ICI Rx Cancer pts was no worse when RA pts took ICIs (1.09; 0.94–1.25). Cause of death similar; Infx were rare (<1.0%) https://t.co/3ZYujU5nyE https://t.co/MCDcdWHcVx
Dr. John Cush
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In this week's RheumIQ quiz: An RA patient has a current or new cancer. With which cancer should you avoid/stop the use of a TNF inhibitor? See if you got it right at https://t.co/DTabBEfjj9 https://t.co/tVYUEjAPy3
Dr. John Cush
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Medicare analysis of RA pts w/ metastatic nonsmall cell lung CA (mNSCLC) looked at 663 ICI-treated pts - 46% Rx w/ glucocorticoids (median Pred 6.6 mg/d). GC use was not associated with survival outcomes https://t.co/mwQeAgyKTC https://t.co/SR2XRD5Rhx
Dr. John Cush
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Which autoimmune condition carries the highest relative risk for lymphoma? Test your knowledge in the latest RheumIQ quiz at https://t.co/TBlB4pmnKa https://t.co/sx8fpdHgHN
Dr. John Cush
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Malignancies Not Increased with Biologic Therapies
The risk of malignancy in RA patients receiving biologic agents was evaluated by metanalysis of RCTs and found no significant increased risk of malignancy compared with other DMARDs or with placebo.
https://t.co/ZEO4jP5RwA https://t.co/C1YeTSh7ZN
Dr. John Cush
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Screening High Risk Myositis Patients for Cancer
An Italian retrospective study of 411 idiopathic inflammatory myopathies (IIM) patients applied IMACS criteria to assess the risk of cancer and found significantly more cancers in those at high risk.
https://t.co/AHvC5xfsCr https://t.co/Bd4VMRX9PU
Dr. John Cush
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Italian retrospective study 411 IIM pts classified cancer risk per IMACS criteria: 44% high-, 38% intermed- 18% standard-risk. 9.2% had CA w/in 3yrs. Signif more in high-risk (OR 4.05). CA predictors: TIF1γ (OR 12.3), SAE1 (OR = 11.9) https://t.co/j4gA0g79bI https://t.co/Pt5nMs89bl
