Computed tomography for malignancy screening in patients with rheumatoid arthritis before initiation of disease modifying antirheumatic drug
Authors' conclusion
Screening in patients with RA using CT before the initiation of b/tsDMARDs allows for the early detection and treatment of malignancy, resulting in safer and more stable b/tsDMARD treatments.
Study context
- Population
- Patients with active RA before initiation of b/tsDMARDs
- Participants
- 2,192 patients
- Exposure
- CT screening vs regular screening before b/tsDMARD initiation
- Outcome
- Sensitivity for detecting malignancy, CT vs regular screening
Main finding
As reported in the abstract
Malignancy detection
Malignancy diagnosed after CT screening
33
1.5%
Malignancies detected by regular screening
7
Additional malignancies detected by CT screening (including 19 at early stage)
26
Malignancies detectable by regular screening at advanced stage
86%
Observational data: associations, not effects.
Further findings
Low disease activity after 1 year
- Early-stage malignancy, b/tsDMARDs after curative resection
- 80%
- Without malignancy detection after screening
- 70%
- Comparable
5-year incidence of malignancy after b/tsDMARD initiation after CT screening vs RA cohort without CT screening
- Standardized incidence ratio (lower than RA cohort without CT screening)
- 0.35
Original publication
Computed tomography for malignancy screening in patients with rheumatoid arthritis before initiation of disease modifying antirheumatic drug. Rheumatology (Oxford). Published 14 February 2023. doi:10.
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