BIOBADASER III Registry shows No Cancer Risk with b/tsDMARDs Save

A large, real-world cohort study of rheumatoid arthritis (RA) finds patients treated with biologic and targeted synthetic DMARDs (b/tsDMARDs) do not have an increased risk of cancer. 

Researchers used 2000–2023 data for RA patients from the BIOBADASER III registry, a multicentre national registry of patients treated with b/tsDMARDs. 

From a total of 4635 RA patients (mean age 55.5 years; median follow-up 3.6 years) there were 187 incident cancers. The risk for all cancers (excluding NMSC) was expressed as adjusted HRs (95% CI) for each drug compared with those using TNFi (referent): 

• IL-6 inhibitors: HR 1.2 (0.8–1.6)
• Rituximab: HR 0.9 (0.5–1.4)
• JAK inhibitors: 1.2 (0.8–1.8)
• Abatacept: 1.1 (0.8–1.6) for CTLA4-A

Similarly, the risk of nonmelanomatous skin cancers (NMSC) was not elevated with insignificant changes to the adjusted HRs - 0.6 (0.2–1.5) for IL6i, 0.6 (0.2–1.8) for CD20i, 0.7 (0.2–2) for JAKi, and 1.1 (0.5–2.6) for CTLA4-A. 

In this prospective RA cohort starting new aggressive therapies, they found no increased cancer risk associated with any bDMARDs or tsDMARDs compared with TNFi.