Does Biologic Therapy Up the Risk of Second Malignancy in RA Patients?
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Biologics suppress the immune system and as such there remains concerns that these medications could increase the risk of a second cancer diagnosis. “Second malignancy is an increasing challenge, as the survival after the first, primary tumor has improved substantially for most types of cancer,” says Lene Dreyer, MD, University of Copenhagen and a lead author of the study.
A total of 1,678 RA patients with a primary cancer diagnosis were selected for analysis from a national medical database in Denmark, from 2000 to 2011. A biologic was received by 502 of these patients; 190 received biologics only before primary cancer diagnosis, 220 received biologics only after their diagnosis and 92 received biologics both before and after their primary cancer diagnosis.
The hazard ratio (HR) for developing a second malignancy was 1.11 vs. 1.00 for those who were never treated with a biologic; this was not deemed statistically significant. Regarding mortality rates, after adjustments were made for age, gender, calendar time, site and extent of the cancer, the hazard ratio for death was 1.20 for RA patients treated with a biologic only before their diagnosis vs. 1.00 for those never treated with a biologic.
Patients treated with a biologic only after their cancer diagnosis had a HR of 1.36 for death. Those who received biologics both before and after their diagnosis had a 1.22 HR for death. “Further studies are required to confirm our findings,” said Dr. Dreyer. “In the meantime, our data does provide some reassurance that biologics don't pose an immediate danger in patients with a history of cancer.” The findings of the study were presented at the 2017 ACR/ARHP Annual Meeting being held in San Diego.
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