RESEARCHERS have found that among patients with rheumatoid arthritis and prior cancer, advanced therapies have not been linked to a clearly different risk of new primary cancer, locoregional progression, or metastasis compared with conventional synthetic therapies.
Using advanced therapies in patients with rheumatoid arthritis (RA) and a history of cancer remains challenging, as both disease activity and advanced therapies may increase cancer risk. Evidence in this population has remained very limited. Therefore, researchers sought to assess cancer risk with advanced therapies, particularly non-tumour necrosis factor inhibitor biologic and targeted synthetic disease-modifying antirheumatic drugs (DMARDs).
The ARthritis and CAncer (ARCA) registry was a nationwide retrospective study of 728 patients with RA and prior cancer, collecting RA characteristics, DMARDs received, cancer type and demographics.
Researchers investigated the occurrence of new primary cancer, locoregional progression or metastasis during follow-up in patients receiving tumour necrosis factor inhibitors, IL6-inhibitors, CD20 inhibitors, targeted synthetic DMARDs and cytotoxic T-lymphocyte-associated protein 4-analogue. Risk was compared with that for conventional synthetic DMARDs (csDMARDs) using adjusted Cox regression models to estimate hazard ratios (HRs).
Among 728 patients with RA, 80 cases of cancer were identified over a cumulative exposure period of 11,022 years, with an overall cancer incidence rate of 7.3 per 1000 person-years (95% CI: 5.8 to 9.0).
Compared with csDMARDs, adjusted HRs for all cancers were 0.94 for tumour necrosis factor inhibitors, 1.03 for IL6-inhibitors, 0.81 for CD20 inhibitors, 0.6 for targeted synthetic DMARDs and 0.74 for cytotoxic T-lymphocyte-associated protein 4-analogue.
No differences in cancer risk were observed after adjusting for duration of exposure, line of advanced therapy, or prior cancer status.
These real-world data have not identified differences in cancer risk across DMARD strategies in patients with rheumatoid arthritis and prior cancer, contributing evidence that may help inform therapeutic decision-making. Further research will be needed to confirm these findings.
Reference
Molina-Collada J et al. Risk of new primary cancer, locoregional progression or metastasis associated with bDMARDs and tsDMARDs in patients with rheumatoid arthritis and prior cancer: insights from the ARCA registry. RMD Open. 2026;12:e007113.
Featured image: bongkarn on Adobe Stock
bongkarn on Adobe Stock
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