Rheumatoid arthritis: anti-TNF use tied to increased risk for non-melanoma skin cancer

  • Wang JL & al.
  • Clin Rheumatol
  • 10 Dec 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • The risk for nonmelanoma skin cancer (NMSC) was higher in rheumatoid arthritis (RA) patients treated with tumour necrosis factor inhibitors (anti-TNF) compared with those without anti-TNF.
  • The risk was more pronounced for squamous cell skin cancer (SCC).

Why this matters

  • Findings suggest that anti-TNF may be avoided in RA patients who are at high risk of NMSC.

Study design

  • Meta-analysis of 6 studies that compared the risk of NMSC in RA patients treated with anti-TNF drugs vs those without anti-TNF (n=123031).
  • Funding: supported by the National Natural Science Foundation of China and others.

Key results

  • RA patients treated with anti-TNF vs those without anti-TN were at an increased for NMSC (relative risk [RR] 1.28, 95% CI, 1.19-1.38; I2=45.6%, P=.056).
  • In the subgroup meta-analysis by type of NMSC, anti-TNF use in RA patients was associated with increased risk for SCC (RR 1.30, 95% CI, 1.09-1.54; I2= 0%, P=.854), but not basal cell skin cancer (RR 1.13, 95% CI 0.97-1.31; I2= 0%, P=.555).

Limitations

  • Risk of bias.