Use of Biologic or Targeted Synthetic Disease-Modifying Antirheumatic Drugs and Cancer Risk
Authors' conclusion
In this cohort study of individuals with RA and new biologic or targeted synthetic DMARD exposures, individuals initiating rituximab, abatacept, and JAKis demonstrated higher incidence rates and statistically significantly increased risks of incident cancers compared with those initiating TNFis in the first 2 years after initiation of biologic or targeted synthetic DMARDs.
Study context
- Population
- US individuals aged 18 to 64 years with rheumatoid arthritis (RA) initiating b/tsDMARDs, Marketscan claims, November 1, 2012, to December 31, 2021 (79% female; median age 50 years)
- Participants
- 27,661 drug exposures
- Exposure
- Rituximab, abatacept, IL-6is or JAKis vs Tumor Necrosis Factor Inhibitors (TNFis)
- TNFisn = 20,586reference
- JAKisn = 2,570
- Abataceptn = 2,255
- Rituximabn = 1,182
- IL-6isn = 1,068
- Outcome
- Incident cancer, excluding nonmelanoma skin cancer, after at least 90 days and within 2 years of b/tsDMARD initiation
- Follow-up
- Within 2 years
Methodological detailsUS administrative claims data (Merative Marketscan), new-user design, multivariable Cox proportional hazards regression
- US administrative claims data (Merative Marketscan)
- New-user design
- Multivariable Cox proportional hazards regression
Main finding
As reported in the abstract
Incident cancer (excl. nonmelanoma skin cancer)
Each group vs TNFisHazard ratio (95% CI)
Rituximab
1.91(1.17–3.14)
Abatacept
1.47(1.03–2.11)
JAKis
1.36(0.94–1.96)
Observational data: associations, not effects.
Original publication
Use of Biologic or Targeted Synthetic Disease-Modifying Antirheumatic Drugs and Cancer Risk. JAMA Netw Open. Published 4 November 2024. doi:10.
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