Biologic therapies developed in the last decade for rheumatoid arthritis are not associated with an increased risk of cancer when compared with traditional treatments for the condition, according to new research from The University of Texas MD Anderson Cancer Center.
The study, published in The Journal of the American Medical Association (JAMA), is the largest systematic review evaluating the risk of developing any malignancy among rheumatoid arthritis patients using approved biologic response modifiers (BRMs), several of which include tumor necrosis factor (TNF) inhibitors. Since 2005, conflicting data has associated TNF inhibitors with an increased risk of developing certain types of malignancies. Because of increased cases of spontaneous lymphoma in children and adolescents, the current US Food and Drug Administration warning label notes the risk of malignancy for all TNF inhibitors.
"These results are reassuring for patients considering biologic therapies for their disease," says senior author Maria E. Suarez-Almazor, M.D., professor in the Department of General Internal Medicine at MD Anderson. "Patients are understandably concerned when treatments are linked to cancer risk. With this knowledge, clinicians can effectively demonstrate that the benefits of BRMs far outweigh the risk."
Rheumatoid arthritis affects approximately one percent of the population and can lead to significant morbidity, joint deformity and impaired quality of life. Traditional treatments for rheumatoid arthritis include disease-modifying anti-rheumatic drugs (DMARDs), like methotrexate, and anti-inflammatory medications.
BRMs are prescribed as a second line of treatment if the initial DMARDs fail. BRMs target molecules on cells of the immune system and joints, and the products that are secreted in the joints, all of which can cause inflammation and joint destruction. Between 25 and 56 percent of patients use BRMs to treat the disease, but concerns over cancer risk abound because the therapies interfere with the immune system.