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Clinical context for cancer risk of immunosuppressive agents used in dermatology

Timothy Tyler Daugherty1, Robert Andrew Swerlick2

  • 1Emory University School of Medicine, Atlanta, Georgia, USA.

Dermatologic Therapy
|October 21, 2020
PubMed

Insights

Small molecules and biologic therapies offer significant benefits for inflammatory skin conditions but carry cancer risks. This review provides clinical context on malignancy risks to aid patient counseling and treatment decisions.

Area of Science:

  • Dermatology
  • Rheumatology
  • Oncology

Background:

  • Dermatologic care for inflammatory skin conditions has advanced with small molecules, disease-modifying anti-rheumatic drugs (DMARDs), and targeted biologics.
  • While beneficial, these therapies raise concerns about potential side effects, notably an increased risk of cancer.

Purpose of the Study:

  • To review current information on malignancy risks associated with small molecule, DMARD, and biologic therapies used in treating skin diseases.
  • To provide clinical context for these risks, including Number Needed to Harm (NNH) estimates, to improve patient guidance and counseling.

Main Methods:

  • Literature review of available data on cancer risk in patients undergoing treatment with small molecules, DMARDs, and biologics for dermatologic conditions.
  • Inclusion of Number Needed to Harm (NNH) calculations where data permits to quantify risk.

Main Results:

  • The review synthesizes information on the association between specific therapeutic agents and the risk of developing malignancies.
  • NNH estimates are presented to contextualize the magnitude of cancer risk relative to treatment duration and patient numbers.

Conclusions:

  • Understanding the specific cancer risks associated with immunomodulatory therapies is crucial for informed clinical decision-making.
  • Improved patient counseling regarding potential adverse events, including malignancy risk, is essential when initiating or continuing these treatments.
Keywords:
absolute riskcancercancer riskimmunosuppressionmalignancyrelative riskskin cancer

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