Repeat Malignancy Unlikely with Biologic Therapy Save

Research from the Danish biologics registry shows that the use of a biologic in patients with a history of a primary cancer does not increase the risk of a second malignant neoplasm (SMN) or mortality in rheumatoid arthritis (RA) patients.

They analyzed 15,286 RA patients in the DANBIO Register between 2000–2011 and found 1678 with a primary cancer.  The majority (1203) did not use biologics after. 

279 patients with RA contributing person-years to the bDMARDs use before their primary cancer diagnosis, 220 to the only after, 92 to the both before and after, while 1203 patients with RA contributed to the non-use strata.

Compared to no biologic use, ever use of bDMARDs was not associated with an increased risk of a second malignant neoplasm (HR 1.11; 95% CI 0.74 to 1.67).  Like wised the adjusted risk for death following a SMN was not increased (HR 1.36; 95% CI 0.78 to 2.39) for bDMARD use after primary cancer or for use both before and after the cancer (HR 1.22; 95% CI 0.70 to 2.13).

These data underscore the need to use the most effective anti-rheumatic treatment, especially biologics, in RA patients with or without cancer. Treatment with bDMARDs was not associated with increased risk of SMN.