Title

Therapy with Biologic Agents After Diagnosis of Solid Malignancies: Results from the Corrona Registry

UMMS Affiliation

Department of Emergency Medicine

Publication Date

2019-11-01

Document Type

Article

Disciplines

Analytical, Diagnostic and Therapeutic Techniques and Equipment | Immune System Diseases | Musculoskeletal Diseases | Neoplasms | Rheumatology | Skin and Connective Tissue Diseases

Abstract

OBJECTIVE: Guidelines suggest that rheumatoid arthritis (RA) patients with previously treated solid malignancy may be treated as patients without such history. The recommendation is based on limited evidence, and rheumatologists and patients are frequently hesitant to start or continue biologic therapy after a cancer diagnosis. The objective of this study was to describe biologic use in real-world patients with RA following a malignancy diagnosis.

METHODS: RA patients enrolled in the Corrona registry and diagnosed with solid malignancy with at least 1 followup visit within 12 months after diagnosis were included in this analysis. The proportion of patients continuing or initiating biological/targeted synthetic disease-modifying antirheumatic drug (bDMARD/tsDMARD) after diagnosis was estimated. Median time to initiation of bDMARD/tsDMARD after diagnosis was calculated using the Kaplan-Meier method and the proportion initiating biologic treatment in 6-month time intervals was estimated using the life-table method.

RESULTS: There were 880 patients who met inclusion criteria with 2585 person-years total followup time postdiagnosis. Of those, 367 (41.7%) were treated with bDMARD/tsDMARD within 12 months preceding malignancy, of whom 270 (30.7%) were taking such agents at first postdiagnosis visit. Forty-four (5%) switched biologic agents within 36 months and an additional 90 patients (10.2%) started a biologic. The majority of bDMARD/tsDMARD initiations during followup was a tumor necrosis factor inhibitor (TNFi; 53.5%).

CONCLUSION: In real-world practice, nearly one-third of RA patients with a cancer diagnosis were treated with systemic therapy in the immediate visit after malignancy diagnosis and a considerable percentage of malignancy survivors initiated biologic therapy within 3 years. The majority of bDMARD/tsDMARD initiations post-malignancy diagnosis was a TNFi.

Keywords

biologics, malignancy, rheumatoid arthritis

DOI of Published Version

10.3899/jrheum.171457

Source

J Rheumatol. 2019 Nov;46(11):1438-1444. doi: 10.3899/jrheum.171457. Epub 2019 Apr 1. Link to article on publisher's site

Journal/Book/Conference Title

The Journal of rheumatology

Related Resources

Link to Article in PubMed

PubMed ID

30936285

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