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Malignancy and biologic therapy in rheumatoid arthritis
1Department of Medicine, Clinical Epidemiology Unit, Karolinska University Hospital and Karolinska Institute, Sweden. johan.askling@ki.se
Current Opinion in Rheumatology
|April 5, 2008
Summary
Biological therapies for rheumatoid arthritis may impact cancer risk, but current data are inconclusive. Further research is needed to understand the long-term effects on cancer development, prognosis, and relapse.
Area of Science:
- Immunology
- Oncology
- Rheumatology
Background:
- Inflammatory response systems play a role in human carcinogenesis.
- Biological therapies, particularly anti-tumor necrosis factor (anti-TNF) agents, are used to treat rheumatoid arthritis.
- Uncertainty exists regarding the safety profile of biological therapies concerning malignancy due to their interference with inflammatory pathways.
Purpose of the Study:
- To review the pattern of cancer in rheumatoid arthritis patients not treated with biologics.
- To summarize published data on cancer risk in rheumatoid arthritis patients treated with biologics, focusing on anti-TNF therapy.
Main Methods:
- Literature review of published data.
- Analysis of cancer patterns in rheumatoid arthritis patients.
- Evaluation of cancer risk associated with biologic therapy, primarily anti-TNF agents.
Main Results:
- Current data do not definitively exclude clinically significant increases in cancer risk with biologic therapy.
- Published data also do not refute potential beneficial effects of biologics on cancer.
- Existing safety data from trials and clinical practice may not capture the impact of early carcinogenesis events or sustained biologic exposure.
Conclusions:
- The long-term cancer safety profile of biological therapies remains uncertain.
- Further investigation is required to address the impact of biologics on de-novo cancer development, prognosis, progression, and relapse.
- Methodological challenges in studying delayed and multifactorial events like cancer complicate safety assessments.
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