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Use of Disease‐Modifying Antirheumatic Drugs in Rheumatoid Arthritis: Supporting Shared Decision‐Making Between Patients With Cancer and Clinicians

Use of Disease‐Modifying Antirheumatic Drugs in Rheumatoid Arthritis: Supporting Shared... Newer disease‐modifying antirheumatic drugs (DMARDs) hold promise for improving quality of life and reducing disability related to rheumatoid arthritis (RA) (1). However, enthusiasm for the use of these agents has been tempered by concern for a potentially increased risk of malignancy (2), a particular concern for the substantial number of people with RA who have or are at an increased risk for developing cancer (3).A US Food and Drug Administration (FDA) black box warning attached to these agents cautions of the risk of incident lymphoma associated with tumor necrosis factor inhibitors (TNFi). However, this is based on the results of older studies (4). More recent work, including meta‐analyses of multiple large population‐based studies of the use of TNFi in patients with RA, has failed to find an increased risk of lymphoma among those receiving these agents (5,6). Nonetheless, the FDA warning undoubtedly continues to raise concern in the minds of patients and clinicians regarding the safety of these agents.In this context, how to treat patients with RA diagnosed with an active or recent (within 5 years of diagnosis) cancer presents a challenging clinical conundrum. Theoretical concern that biologic and other immunosuppressive agents may increase susceptibility to malignancy may make clinicians http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png ACR Open Rheumatology Wiley

Use of Disease‐Modifying Antirheumatic Drugs in Rheumatoid Arthritis: Supporting Shared Decision‐Making Between Patients With Cancer and Clinicians

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References (22)

Publisher
Wiley
Copyright
© 2023 The Authors. ACR Open Rheumatology published by Wiley Periodicals LLC on behalf of American College of Rheumatology.
eISSN
2578-5745
DOI
10.1002/acr2.11552
Publisher site
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Abstract

Newer disease‐modifying antirheumatic drugs (DMARDs) hold promise for improving quality of life and reducing disability related to rheumatoid arthritis (RA) (1). However, enthusiasm for the use of these agents has been tempered by concern for a potentially increased risk of malignancy (2), a particular concern for the substantial number of people with RA who have or are at an increased risk for developing cancer (3).A US Food and Drug Administration (FDA) black box warning attached to these agents cautions of the risk of incident lymphoma associated with tumor necrosis factor inhibitors (TNFi). However, this is based on the results of older studies (4). More recent work, including meta‐analyses of multiple large population‐based studies of the use of TNFi in patients with RA, has failed to find an increased risk of lymphoma among those receiving these agents (5,6). Nonetheless, the FDA warning undoubtedly continues to raise concern in the minds of patients and clinicians regarding the safety of these agents.In this context, how to treat patients with RA diagnosed with an active or recent (within 5 years of diagnosis) cancer presents a challenging clinical conundrum. Theoretical concern that biologic and other immunosuppressive agents may increase susceptibility to malignancy may make clinicians

Journal

ACR Open Rheumatology – Wiley

Published: Jun 1, 2023

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