No Increased Risk of Malignancy in PsA Patients Treated With TNFi

Two oral abstract presentations today offered reassuring results for both users and prescribers of TNFi.

Dr. Karen Fagerli (Abstract 1848) presented data from the British Society for Rheumatology Biologics Register (BSRBR). Cancer rates in severe PsA patients using TNFi were compared to rates in the general UK population. In 709 patients, with 5956.5 patient-years of follow-up, a reassuringly low number of malignancies occurred -- just 34 cases in 32 patients. The most prevalent cancers were non-melanoma skin cancers, followed by malignant melanoma. The standardized incidence ratio (SIR) for cancer overall was 0.94 (95% CI 0.65-1.34). There was an increased SIR for non-melanoma skin cancer of 2.12 (95% CI 1.19-3.50).

Dr. Huifeng Yun (Abstract 1849) examined the risk of malignancy among US Medicare patients with PsA and PsO. This study excluded non-melanoma skin cancer and looked at patients who were treated with a systemic agent or UV therapy. As with the BSRBR data, there was no signal that TNFi use was associated with malignancy. Interestingly, use of etanercept was associated with a lower risk of malignancy (hazard ratio about 0.5) when compared with non-biologic systemic therapy.

The next time a patient asks about cancer risk while using a TNFi, there is now more information we can provide to help them arrive at treatment decisions.

More reports from ACR 2014