A Practical Approach to the Use of Conventional Synthetic, Biologic and Targeted Synthetic Disease Modifying Anti-Rheumatic Drugs for the Treatment of Inflammatory Arthritis in Patients with a History of Malignancy

Purpose of Review Conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) have been used in the treatment of inflammatory arthritis (IA) for many years. More recently, biologic (bDMARDs) and targeted synthetic (tsDMARDs) DMARDs have further improved treatment. Due to increased patie...

Full description

Saved in:
Bibliographic Details
Published in:Current rheumatology reports 2018-10, Vol.20 (10), p.64-64, Article 64
Main Authors: Wong, Peter K. K., Bagga, Hanish, Barrett, Claire, Chong, Geoff, Hanrahan, Patrick, Kodali, Teja, Marabani, Mona, Prince, H. Miles, Riordan, John, Swarbrick, Phillip, White, Ray, Young, Laurel
Format: Article
Language:English
Subjects:
Medicine
Medicine & Public Health
Rheumatoid Arthritis (L Moreland
Rheumatology
Section Editor
Topical Collection on Rheumatoid Arthritis
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose of Review Conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) have been used in the treatment of inflammatory arthritis (IA) for many years. More recently, biologic (bDMARDs) and targeted synthetic (tsDMARDs) DMARDs have further improved treatment. Due to increased patient longevity and effective oncology treatment, rheumatologists often encounter patients with IA and previous malignancy. The immunosuppressive effect of DMARDs causes concern regarding impaired tumour surveillance with a potential increased risk of malignancy. We reviewed the literature regarding the risk of malignancy in patients on cs-/b-/tsDMARDS and sought to provide practical advice regarding use of these drugs in patients with previous malignancy. Recent Findings Data from randomised controlled trials is limited as patients with pre-existing malignancy are often excluded. Reassuringly, an increasing range of “real world” data from various national b/tsDMARD registries has not provided a convincing signal that these drugs increase tumour recurrence. Nevertheless, awareness of, and adherence to, national screening guidelines for malignancy is important. Summary Given the improvement in quality of life achieved with these novel and well-tolerated therapeutic agents, the benefit/risk profile remains overwhelmingly favourable in most patients.
ISSN:1523-3774
1534-6307
DOI:10.1007/s11926-018-0774-9