- Abatacept, a biological (b) DMARD, is associated with melanoma, but not other cancer types, when compared with other bDMARDs in a worldwide observational cohort of patients with rheumatoid arthritis (RA).
Why this matters
- The authors recommend that patients with RA receiving abatacept be monitored for melanoma, pending the outcome of other studies.
- The finding has biological plausibility because:
- Abatacept is a cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) agonist.
- The CTLA-4 inhibitor is approved for the treatment of malignant melanoma.
- Observational retrospective cohort (306,414 patients with RA) data from VigiBase, the WHO's global database of individual case safety reports from >130 countries (2007-2017).
- Funding: None.
- Abatacept (vs other bDMARDs) was not associated with an increased risk for cancer overall:
- Reporting OR, 0.98 (95% CI, 0.91-1.05).
- Abatacept (vs other bDMARDs) was associated with a 56% increased risk for melanoma:
- Reporting OR, 1.56 (95% CI, 1.17-2.08).
- It was not associated with other cancer types (including breast, lung, lymphoma, and nonmelanoma skin cancer).
- Retrospective observational design.