Malignancy and rheumatoid arthritis: Epidemiology,risk factors and management |
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| Affiliation: | 1. Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, University of Manchester, Manchester, United Kingdom;2. National Institute of Health Research Manchester Biomedical Research Centre, Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom;1. Myositis Center and Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA;2. VA Pittsburgh Healthcare System, Pittsburgh, PA, USA;1. Mid-North Coast Arthritis Clinic, Coffs Harbour and University of New South Wales Rural Clinical School, PO Box 6307, Coffs Harbour, NSW, 2450, Australia;2. Private Rheumatology Practice, South Perth, WA and Medical School, University of Western Australia, 13/38 Meadowvale Avenue, South Perth, WA, 6151, Australia;1. Department of rheumatology, Pierre Zobda-Quitman university, Hospital of Martinique, route de Chateauboeuf, 97261 Fort-de-France, Martinique;2. Department of internal medicine, Andrée-Rosemon Hospital, rue des Flamboyants, 97306 Cayenne, French Guiana;3. Department of epidemiology and biostatistics, Pierre Zobda-Quitman university, Hospital of Martinique, route de Chateauboeuf, 97261 Fort-de-France, Martinique;1. Division of Rheumatology, Immunology, and Allergy, Brigham and Women’s Hospital, Boston, MA;2. Division of Pharmacoepidemiology, Brigham and Women’s Hospital, Boston, MA;3. Division of Rheumatology, Albany Medical College, Albany, NY;4. Division of Rheumatology, Massachusetts General Hospital, Boston, MA;5. Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL;6. Division of Rheumatology, University of Massachusetts Medical School, Worcester, MA;7. Division of Rheumatology and Clinical Immunology, Department of Medicine and Division of Gerontology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD;8. Department of Biostatistics, University of Massachusetts Medical Center, Worcester, MA;9. Clinical Trials Unit, Division of Rheumatology, New York University School of Medicine, New York, NY;1. Division of Rheumatology, Johns Hopkins University School of Medicine, 5501 Hopkins Bayview Circle, Arthritis Center, Baltimore, MD, 21224, USA;2. Division of Rheumatology, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Mason F. Lord Center Tower, Suite 4100, Baltimore, MD, 21224, USA |
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| Abstract: | Rheumatoid arthritis (RA) is a chronic inflammatory condition that can result in pain and functional disability. It is also associated with an increased occurrence of comorbidities, including an increased risk of certain cancers such as lung cancer and lymphoma. The aetiopathogenesis of this increased cancer risk is likely multifactorial and includes shared risk factors as well as chronic inflammation. There is also a concern that the treatment for RA itself may increase this risk further, particularly treatment with biologic disease-modifying anti-rheumatic drugs (DMARDs). This paper aims to review the evidence for the increased risk of cancer in RA as well as the latest evidence for the association between DMARDs and tumorigenesis. It also discusses the evidence for the management of patients with biologic DMARDs in the setting of existing cancer. |
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| Keywords: | Rheumatoid arthritis Disease-modifying anti-rheumatic therapies Biologics Malignancy |
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