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journal article Nov 14, 2022

Risk of Cancer After Initiation of Targeted Therapies in Patients With Rheumatoid Arthritis and a Prior Cancer: Systematic Review With Meta‐Analysis

Amélie Wetzman ORCID Cédric Lukas Cécile Gaujoux‐Viala Ronac Mamtani ORCID Thomas Barnetche Bernard Combe ORCID Jacques Morel ORCID Paulina Szafors ORCID
Arthritis Care & Research Vol. 75 No. 2 pp. 260-271 · Wiley
View at Publisher Save 10.1002/acr.24784
Abstract
ObjectiveTo determine the risk of recurrent or new malignancy with exposure to targeted disease‐modifying antirheumatic drugs (DMARDs) in adults with rheumatoid arthritis (RA), axial spondyloarthritis (SpA), or psoriatic arthritis (PsA) and a history of cancer.MethodsWe performed a systematic search of the literature for articles published up to June 2019 that investigated adults with RA, axial SpA, or PsA who had a history of cancer and received biologic or targeted synthetic DMARDs (bDMARDs or tsDMARDs). We compared the risk of relapse or occurrence of new cancer between patients with and without bDMARDs. Rate ratios (RRs) with 95% confidence intervals (95% CIs) were estimated. The heterogeneity of the studies was evaluated by the Cochran Q test and the I2 statistic.ResultsWe included 24 observational studies of chronic inflammatory arthritis; of those, 12 were included in the meta‐analysis of RA patients receiving bDMARDs. As compared with RA patients with a history of cancer and not receiving bDMARDs, for those receiving any bDMARD, the overall RR for risk of neoplasia was 1.09 (95% CI 0.92–1.32; P = 0.31, I2 = 8%); with tumor necrosis factor inhibitors, it was 1.11 (95% CI 0.85–1.46; P = 0.45, I2 = 48%); and with rituximab, it was 0.79 (95% CI 0.41–1.53; P = 0.49, I2 = 0%). The RR for risk of recurrence for skin cancer was 1.32 (95% CI 1.02–1.72; P = 0.04, I2 = 0%) and for breast neoplasia 1.21 (95% CI 0.84–1.72; P = 0.31, I2 = 0%).ConclusionApart from skin cancers including melanoma, the risk of recurrent or new cancer is not increased with the initiation of bDMARDs for RA as compared with no bDMARDs.
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Cited By
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Long-term risk of de novo malignancy with tumor necrosis factor alpha (TNF) inhibitor immunosuppression: a multicenter, retrospective cohort study

Conor B. Driscoll, Jordan M. Rich · 2025

Journal of Inflammation
Metrics
26
Citations
50
References
Details
Published
Nov 14, 2022
Vol/Issue
75(2)
Pages
260-271
License
View
Authors
A
Amélie Wetzman

University of Montpellier Montpellier France

C
Cédric Lukas

University of Montpellier Montpellier France

C
Cécile Gaujoux‐Viala

University of Montpellier, Montpellier, and Nîmes University Hospital Nîmes France

R
Ronac Mamtani

University of Pennsylvania Philadelphia

T
Thomas Barnetche

Fédération Hospitalo‐Universitaire and Centre Hospitalier Universitaire Pellegrin Bordeaux France

B
Bernard Combe

University of Montpellier Montpellier France

J
Jacques Morel

University of Montpellier Montpellier France

P
Paulina Szafors

University of Montpellier Montpellier France

Cite This Article
Amélie Wetzman, Cédric Lukas, Cécile Gaujoux‐Viala, et al. (2022). Risk of Cancer After Initiation of Targeted Therapies in Patients With Rheumatoid Arthritis and a Prior Cancer: Systematic Review With Meta‐Analysis. Arthritis Care & Research, 75(2), 260-271. https://doi.org/10.1002/acr.24784
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