An increased risk of non-melanoma skin cancer during TNF-inhibitor treatment in psoriasis patients compared to rheumatoid arthritis patients probably relates to disease-related factors

2014 ◽  
Vol 29 (4) ◽  
pp. 752-760 ◽  
Author(s):  
P.P.M. van Lümig ◽  
S.P. Menting ◽  
J.M.P.A. van den Reek ◽  
P.I. Spuls ◽  
P.L.C.M. van Riel ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Skin Cancer ◽  
Tnf Inhibitor ◽  
Related Factors ◽  
Non Melanoma Skin Cancer ◽  
Increased Risk ◽  
Inhibitor Treatment ◽  
Melanoma Skin

Pharmacologic Immunomodulation and Cutaneous Malignancy in Rheumatoid Arthritis, Psoriasis, and Psoriatic Arthritis

2010 ◽  
Vol 37 (11) ◽  
pp. 2205-2215 ◽  
Author(s):  
MICHAEL S. KRATHEN ◽  
ALICE B. GOTTLIEB ◽  
PHILIP J. MEASE
Keyword(s):  
Rheumatoid Arthritis ◽  
Psoriatic Arthritis ◽  
Skin Cancer ◽  
Cell Carcinoma ◽  
English Language ◽  
Immunomodulatory Therapy ◽  
Cutaneous Malignancy ◽  
Non Melanoma Skin Cancer ◽  
Necrosis Factor ◽  
Melanoma Skin

Objective.It is unclear if skin cancer risk is affected by the use of immunomodulatory medications in rheumatoid arthritis (RA), psoriasis, and psoriatic arthritis (PsA). The purpose of this study is to evaluate and summarize the available data pertinent to this question.Methods.The English language literature on PubMed was searched with a combination of phrases, including “malignancy,” “skin cancer,” “squamous cell carcinoma,” “basal cell carcinoma,” “melanoma,” “psoriasis,” “psoriatic arthritis,” and “rheumatoid arthritis” in addition to the generic names of a variety of common immunomodulatory drugs. Relevant articles were identified and data were extracted.Results.In total, 2218 potentially relevant articles were identified through the search process. After further screening, 20 articles relevant to RA were included. An additional 19 articles relevant to either psoriasis or PsA were included as well. RA may be a risk factor for the development of cutaneous malignancy. Treatment with tumor necrosis factor inhibitors increases the rates of non-melanoma skin cancer (NMSC) in RA and psoriasis. This risk doubles when combination methotrexate therapy is used in RA. Methotrexate may increase the risk of malignant melanoma in patients with RA and the risk of NMSC in psoriasis. Cyclosporine and prior phototherapy significantly increase the risk of NMSC.Conclusion.RA may potentiate the risk of cutaneous malignancy and therefore dermatologic screening in this population should be considered. The use of immunomodulatory therapy in RA, psoriasis, and PsA may further increase the risk of cutaneous malignancy and therefore dermatologic screening examinations are warranted in these groups. More careful recording of skin cancer development during clinical trials and cohort studies is necessary to further delineate the risks of immunomodulatory therapy.

A new hypothesis to explain skin cancer risk in kidney allograft recipients

2020 ◽  
pp. 239936932097212
Author(s):  
Davide Viggiano ◽  
Michael W Lee ◽  
Mariadelina Simeoni ◽  
Giovambattista Capasso ◽  
Anna Capasso
Keyword(s):  
Skin Cancer ◽  
Cell Carcinoma ◽  
Cancer Incidence ◽  
Calcineurin Inhibitors ◽  
Non Hodgkin Lymphoma ◽  
Non Melanoma Skin Cancer ◽  
Incident Cancer ◽  
Increased Risk ◽  
New Hypothesis ◽  
Melanoma Skin

Kidney transplant (KT) recipients have an increased risk for specific types of cancer. Some forms of incident cancer are similarly present in other diseases where T-cells are depleted, such as HIV-infection: specifically, non-Hodgkin lymphoma and Kaposi’s sarcoma. Conversely, other forms of highly incident cancers in KT patients, primarily non-melanoma skin cancer (squamous cell carcinoma and basal cell carcinoma), are specific to this condition. By comparing HIV-related cancers, general cancer incidence, and the association of immunotherapy with cancer incidence, we suggest that the high incidence of non-melanoma skin cancer seen in KT patients is mediated by off-target effects of calcineurin inhibitors in the skin, combined with a “permissive” cancer microinflammatory environment.

scholarly journals Abatacept initiation in rheumatoid arthritis and the risk of cancer: a population-based comparative cohort study

Rheumatology ◽  
2018 ◽  
Vol 58 (4) ◽  
pp. 683-691 ◽  
Author(s):  
François Montastruc ◽  
Christel Renoux ◽  
Sophie Dell’Aniello ◽  
Teresa A Simon ◽  
Laurent Azoulay ◽  
...  
Keyword(s):  
Cohort Study ◽  
Skin Cancer ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Non Melanoma Skin Cancer ◽  
Increased Risk ◽  
Significant Difference ◽  
Specific Cancer ◽  
Risk Of Cancer ◽  
Melanoma Skin

Abstract Objective To assess whether abatacept as initial biological DMARD (bDMARD) in the treatment of RA, when compared with other bDMARDs, is associated with an increased risk of cancer overall and by specific cancer sites (breast, lung, lymphoma, melanoma and non-melanoma skin cancer). Methods We performed a population-based cohort study among patients newly treated with bDMARDs within the US-based Truven MarketScan population and Supplemental US Medicare from 2007 to 2014. Cox proportional hazards models were used to estimate hazard ratios and 95% CIs of any cancer (and specific cancers) associated with initiation of abatacept, compared with initiation of other bDMARDs, adjusted for age and deciles of the propensity score. Results The cohort included 4328 patients on abatacept and 59 860 on other bDMARDs, of whom 409 and 4197 were diagnosed with any cancer during follow-up (incidence rates 4.76 per 100 per year and 3.41 per 100 per year, respectively). Compared with other bDMARDs, the use of abatacept was associated with an increased incidence of cancer overall (hazard ratioadjusted 1.17; 95% CI 1.06, 1.30). Analyses by specific cancer sites showed a significantly increased incidence of non-melanoma skin cancer (hazard ratioadjusted 1.20; 95% CI 1.03, 1.39), but no significant difference for other specific cancer sites. Conclusion The use of abatacept as first bDMARD in the treatment of RA was associated with a slight increased risk of cancer overall and particularly non-melanoma skin cancer, compared with other bDMARDs. This potential signal needs to be replicated in other settings.

scholarly journals Predictive Value of the First Non-Melanoma Skin Cancer: A Retrospective Study

2020 ◽  
Vol 78 (1) ◽  
pp. 31-36
Author(s):  
P. M. Garrido ◽  
J. Borges-Costa ◽  
L. Soares-Almeida ◽  
P. Filipe
Keyword(s):  
Retrospective Study ◽  
Skin Cancer ◽  
Hematologic Malignancy ◽  
Histological Type ◽  
Non Melanoma Skin Cancer ◽  
Increased Risk ◽  
Immunosuppressed Patients ◽  
The One ◽  
Melanoma Skin

Introduction: Patients with previous non-melanoma skin cancer have an increased risk of developing another skin cancer and some studies suggest that the histological type of the incident tumour can predict the one of the subsequently diagnosed. The aim of this study was to assess a correlation between the histological type of the first and the subsequent non-melanoma skin cancer diagnosed in immunocompetent patients and in different settings of immunosuppression. Methods: A retrospective study was conducted on all patients without previous skin cancer, with the diagnosis of two or more non-melanoma skin cancer between January 1st, 2008 and December 31th, 2017. Results: A total of 413 patients were included. Fifty-one individuals (12.4%) were immunosuppressed. There was a significative association between the histological type of the first and the subsequent non-melanoma skin cancer diagnosed both in immunocompetent and in immunosuppressed patients, with a higher probability of developing a tumour of the same histological type (p<0.001). This association was also significative in patients with the diagnosis of a hematologic malignancy. The mean interval between the two diagnoses was 30 months (range 7-111). Forty-three patients (10.4%) presented a subsequent tumour after more than five years of follow-up. Conclusion: The histological type of the incident non-melanoma skin cancer predicted the risk of developing another tumour of the same type. For the first time, we showed this correlation in patients with a hematologic malignancy. High-risk individuals may benefit from a long-lasting follow-up of at least ten years.

SAT0097 DO COMORBIDITIES IMPACT PERSISTENCE OF FIRST TUMOR NECROSIS FACTOR INHIBITOR TREATMENT IN RHEUMATOID ARTHRITIS? DATA FROM TURKBIO

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 982.1-982
Author(s):  
T. Yüce İnel ◽  
S. B. Kocaer ◽  
Y. Erez ◽  
S. Gulle ◽  
A. Karakas ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Survival Rate ◽  
Tumor Necrosis Factor Inhibitor ◽  
Inhibitor Therapy ◽  
Response To Treatment ◽  
Treatment Quality ◽  
Tnf Inhibitor ◽  
Increased Risk ◽  
The Impact ◽  
Inhibitor Treatment

Background:Studies indicate that patients with rheumatoid arthritis (RA) are at increased risk of developing several comorbid disorders. Comorbidities affect treatment decisions, the effectiveness of the treatment, quality of life, RA prognosis, and survival rate [1].Objectives:The aim of thisstudyto investigate the impact of comorbidity on the first TNF inhibitor treatment persistence in RA.Methods:In the TURKBIO database, patients with an ICD 10-diagnosis of RA (M05 or M06) who started TNF inhibitor therapy between January 2011 and June 2019 were enrolled. Demographic and clinical characteristics, acute phase reactants, disease activity scores (DAS 28 CRP, HAQ, CDAI, VAS global), initial comorbidities and numbers, drug persistence, were evaluated. Kaplan-Meier plots and Cox proportional hazard regression analyses were performed.Results:A total of 1172 patients >18 years of age treated with TNF-α inhibitors were included in the study. The most prevalent comorbidities were: hypertension in 262 patients (32.6%), obesity in 254 (32.6%), osteoporosis in 178 (22.3%), chronic lung disease in 143 (17.9%) and depression in 126 (15.8%). The baseline characteristics are summarised in Table 1. The presence of comorbidity did not affect the survival rate of the first TNF inhibitor therapy in the RA patients (p: 0.65). Comorbidities had no effect on DAS28 CRP (> 1.2 reduction) responses at 6 and 12 months of treatment (p: 0.18, p: 0.83, respectively). As the mean disease duration increases, the persistence of the first TNF inhibitor decreases by 5%.Conclusion:This study demonstrated the increasing burden of comorbidities in RA. However, it suggested that the presence and number of comorbidities did not influence the rate of persistence in the first TNF inhibitor drug and the response to treatment.References:[1] Gabriel, S.E. and K. Michaud,Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases.Arthritis research & therapy, 2009.11(3): p. 229.Disclosure of Interests:None declared

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