Data from one large U.S. registry indicate that biologic therapy does not appear to increase overall risks of cancers other than skin cancers in patients with rheumatoid arthritis, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in Washington, DC.
Genetically-engineered biologic agents are often prescribed to counter abnormalities in the immune system that can cause joint inflammation. Typically, however, biologics such as adalimumab, etanercept, infliximab, anakinra and abatacept, are used only as a second line therapy because of their costs as well as possible side effects. Most significantly, concern centers on the perceived added risk for serious infections and cancers as biologic agents are used to treat rheumatoid arthritis.
To assess these possible risks, researchers studied 13,000 individuals participating in the National Data Bank of Rheumatic Disease between 1998 and 2005. Participants reported on all drug use, including biologics, as well as all cancers semi-annually. Of these, 48% had taken biologics. Those reporting new cases of non-melanotic skin cancer totaled 623, while 537 new cases were reported for other cancers.
Comparing these cases with the National Cancer Institute’s SEER Database, which tracks cases across the general population, researchers found an increased risk for new melanoma and non-melanotic skin cancer cases in those using biologics. However, there were no significant differences in the risks for all other cancers in this population. Longer follow-up may be required to be certain of the non-association of biologic therapy and tumors other than skin cancers.
“These reports, which confirm registry data studies conducted in Europe, offer valid measurements of cancer rates in rheumatoid arthritis,” explains Frederick Wolfe, MD, Project Director, National Data Bank for Rheumatic Disease, Wichita, Kansas, and an investigator in the study. “While longer follow-up may be required, this data shows the use of biologic therapy is not associated with increased risks of lymphoma, lung cancer or other cancers among those with rheumatoid arthritis.”