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Cancer risk in rheumatoid arthritis: anything new?
Is there a higher risk of cancer that comes with the disease? Or with the treatments? So many confounding parameters, such as disease duration, disease state, and disease activity come into play. A promising session explored comorbidities in Rheumatoid Arthritis, in particular cancer and cardiovascular events. Here are my takeaways.
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No Cancer Recurrence with Biologic DMARDs in RA
A prospective Danish rheumatoid arthritis (RA) registry study look at the risk of recurrence when a biological disease-modifying antirheumatic drugs (bDMARDs) was ued in patients with a a prior solid cancer (in remission) and found no increased cancer
Key summary slide of research in the use of CD19 CAR T cells in rheumatology indications
Dinesh Khanna @RheumNow #EULAR2025 https://t.co/CoFHqaE1L1
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Autologous CAR T cell production, administration and monitoring
Dinesh Khanna @RheumNow #EULAR2025 https://t.co/zrXjxSCRgl
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Should we screen for #lung #cancer in #SSc high risk Pts? When >10 yrs?
Greek cohort of SSc since 1995
Disease duration 12 yrs,
smoking lung ca group ⬆️58% vs 29%
⬆️dcSSc
⬆️immunosuppression
OR >4X lung ca if dcSSc, IS
Less #DU
#PO0940 @RheumNow @eular_org #EULAR2025 https://t.co/L2zEkP8pAc
Links:
Janet Pope Janetbirdope ( View Tweet)
Should we still be worried about lymphoma developing in RA patients?
Incidence has plummeted with modern therapy, although still a small risk. TNFi and other bDMARDs don’t seem to confer any real risk.
So what should our approach be?
Karin Hellgren #EULAR2025 @RheumNow https://t.co/9ZodpojSaz
David Liew drdavidliew ( View Tweet)
The definition of MAS. MAS is secondary HLH. Other causes of secondary HLH are infections, malignancy and iatrogenic.
Georgin-Lavialle S @RheumNow #EULAR2025 https://t.co/CpB78JBlVJ
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Clinical Pearl's for #MAS
Infections are still the most common cause.
Next is malignancy...
Then other causes like autoimmunity..
Ask a detailed history ! Sometimes check with the family when the pt can't give history..
#EULAR2025 @RheumNow https://t.co/fepercz5Af
Bella Mehta bella_mehta ( View Tweet)
JAKi: expanding RMD indications—but important safety concerns to consider
⚠️ Cancer: Neutral vs MTX/placebo, ↑ risk vs TNF
⚠️ Infection: ↑ with age, disease activity & GC use—not uniformly higher with JAKi
🗣️ Patients rank infection risk as top concern
@rheumnow #EULAR2025 https://t.co/RJRDWQjqNC
Links:
Jiha Lee JihaRheum ( View Tweet)
#Cancer is not ⬆️in JAKi vs #bDMARDs in
#rheumatoid #arthritis
When adjusted for #confounders
#JAKPOT data
Now you see it (unadjusted ⬆️risk)
Now you don’t (adjusted =#malignancy)
JAKi vs bDMARDs in RA
EULAR2025 @RheumNow @eular_org
#JAK it out! new perspective on JAKi https://t.co/wCQ3dHNAVa
Links:
Janet Pope Janetbirdope ( View Tweet)
Would you use #CAR-T in #polyrefractory #RA
#EULAR2025 @RheumNow @eular_org
Janet Pope Janetbirdope ( View Tweet)
Clinical determinants of multiple drug failure in D2T RA
2000+ RA cohort 250+ refractory
-Low financial status
-Cancer Hx
-CV comorbidities
-Chronic use of NSAID or GCs
Protective: Regular participation in leisure activities
#POS0030 @RheumNow #EULAR2025 https://t.co/qNHQoHCb80
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
#OP0066 Danish registry study finds no increased risk of cancer recurrence with bDMARDs vs csDMARDs in RA patients with prior solid tumor in remission. IPTW-adjusted HR for any bDMARD: 0.92 (95% CI 0.38–2.21).
📉 TNFi, ,RTX also not associated with recurrence
@RheumNow #EULAR2025
Jiha Lee JihaRheum ( View Tweet)
Worried about cancer risk with ts/bDMARDs in RA?
Real-world data from over 4,600 patients says: don’t be. No increased risk of cancer (incl. NMSC) for JAKi, IL6i, CD20i, or CTLA4-A vs TNFi in long-term registry follow-up.
Abstract#OP0065
@RheumNow #EULAR2025
Jiha Lee JihaRheum ( View Tweet)
135 pts w/ neurologic autoimmune dz (MS, GBS, myasthenia gravis) who had cancer & Rx w/ checkpoint inhibitors (ICI) showed exacerbations in SOME - 18% of MS pts, but 67%of MG, latter often w/ hospitalization (50%) or death (17%). GBS faired well w/ ICI Rx. https://t.co/RksC6QXce0 https://t.co/mYjzgxbcdQ
Dr. John Cush RheumNow ( View Tweet)
Retrospective multicentre study of 122 anti-synthetase syndrome pts - 14 (11%) had cancer associated myositis (CAM). The CAM SIR= 5.4 (elevated vs gen. pop. p < 0.0001). These pts were older, often +Hx cancer, lower CK levels, less weakness, worse survival. CAM cluster= older https://t.co/nuKg3P89a8
Dr. John Cush RheumNow ( View Tweet)
135 pts w/ neurologic autoimmune dz (MS, GBS, myasthenia gravis) who had cancer & Rx w/ checkpoint inhibitors (ICI) showed exacerbations in SOME - 18% of MS pts, but 67%of MG, latter often w/ hospitalization (50%) or death (17%). GBS faired well w/ ICI Rx. https://t.co/RksC6QXce0 https://t.co/HbwYDVrIAt
Dr. John Cush RheumNow ( View Tweet)
No Cancer Recurrence with Biologic DMARDs in RA
A prospective Danish rheumatoid arthritis (RA) registry study look at the risk of recurrence when a biological disease-modifying antirheumatic drugs (bDMARDs) was ued in patients with a a prior solid cancer (in remission) and https://t.co/T7G96cAlE6
Dr. John Cush RheumNow ( View Tweet)
Retrospective Medicare Claims data study of RA pts w/ metastatic non-small cell lung cancer who recv Rx w/ immune checkpoint inhibitor; found that ICI- Rx RA had the same survival as non-RA pts, and sterid use was not associated with worse survival https://t.co/JLlCfrRwvN https://t.co/DNEM32yocL
Dr. John Cush RheumNow ( View Tweet)
DANBIO registry study of 720 RA pts w/ a prior solid cancer (breast, colon. lung, endometrial, melanoma, bladder) in remission who received any biologic DMARD, TNFi or RTX found no incr risk of CA recurrence w/ any bDMARD, TNFi, RTX. Specifically, no incr in breast CA recurrence https://t.co/YJw8qXz1yM
Dr. John Cush RheumNow ( View Tweet)
