Juan Molina-Collada, Chamaida Plasencia-Rodriguez, Verónica García-García, Iván Del Bosque, Marina Pavía-Pascual, Beatriz Villapún Burgoa, Camille Bourgeois-Avella, Montserrat Roig-Kim, Javier Narváez, Isabel Hernández-Rodríguez, Juan Carlos Saez, Cristina Almeida, Alicia García-Dorta, Esther Uriarte Itzazelaia, Daniel Campos, Raquel Dos-Santos, Eva Pérez-Pampín, Francisco Gabriel Jiménez Núñez, Elisa Fernández-Fernández, Alejandro Villalba, Núria Bou, Carolina Pérez-García, Olga Rusinovich Lovgach, Alejandro Martínez Rodado, Roxana González, Francisco José Cepas-Gutiérrez, Otto Olivas-Vergara, Minerva Berrocal, Nuria Molina, Iñigo González Mazón, Esther Toledano, Marina Tortosa-Cabañas, Perceval Vellosillo González, Pablo González Navarro, Victoria Navarro-Compán, Loreto Carmona, ARCA project collaborative group
This real-world data did not identify differences in the risk of new primary cancer, locoregional progression or metastasis across different DMARDs strategies in patients with RA and prior cancer.
OBJECTIVES: To compare the risk of new primary cancer, locoregional progression or metastasis across different disease-modifying antirheumatic drugs (DMARDs) strategies in real-world patients with rheumatoid arthritis (RA) and prior cancer.
METHODS: The ARthritis and CAncer registry is a nationwide retrospective study, including patients with RA and prior cancer. Collected variables included RA characteristics, DMARDs received, cancer type and demographics. The primary outcome was the occurrence of new primary cancer, locoregional progression or metastasis during follow-up. Adjusted Cox regression models were used to estimate HRs for cancer events. Treatment strategies involving conventional synthetic (cs)DMARDs served as the reference for comparison.
RESULTS: 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 (95% CI 5.8 to 9.0) per 1000 person-years. Adjusted HRs for all cancers (95% CI) compared with csDMARDs were 0.94 (0.73 to 1.21) for tumour necrosis factor inhibitors, 1.03 (0.61 to 1.74) for IL6-inhibitors, 0.81 (0.46 to 1.42) for CD20 inhibitors, 0.6 (0.26 to 1.4) for targeted synthetic DMARDs and 0.74 (0.41 to 1.34) 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.
CONCLUSION: This real-world data did not identify differences in the risk of new primary cancer, locoregional progression or metastasis across different DMARDs strategies in patients with RA and prior cancer.