Does biologic therapy for inflammatory disease increase melanoma risk?

  • Esse S & al.
  • JAMA Dermatol
  • 20 May 2020

  • curated by Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • Melanoma risk is not significantly increased with biologic therapy for common inflammatory diseases, according to a systematic review and meta-analysis.

Why this matters

  • The authors cite concerns regarding long-term risk for cancer in patients treated with biologic therapy.

Key results

  • Compared with conventional systemic therapy, biologic treatment was not significantly associated with pooled relative risks (95% CIs) for melanoma in patients with:
    • IBD: 1.20 (0.60-2.40).
    • Rheumatoid arthritis (RA): 1.20 (0.83-1.74). 
    • Psoriasis: 1.57 (0.61-4.09).
  • Compared with conventional systemic therapy, pooled relative risks (95% CIs) for melanoma were not significantly affected by RA treatment with:
    • TNF inhibitor: 1.08 (0.81-1.43).
    • Rituximab: 0.73 (0.38-1.39).
    • Abatacept: 1.43 (0.66-3.09).

Study design

  • 7 cohort studies (34,029 patients treated with biologic therapy and 135,370 biologic-naive patients treated with conventional systemic therapy) were included.
  • Funding: Psoriasis Association.

Limitations

  • Heterogeneity among included studies.
  • Lack of adjustment for related risk factors.