No difference in malignancy rates seen between tocilizumab and TNFi in patients with RA

June 15, 2018

The results of a study presented at the Annual European Congress of Rheumatology (EULAR 2018) examined rates of malignancy in patients with rheumatoid arthritis (RA), excluding non-melanoma skin cancer (NMSC), and found no difference between those newly treated with tocilizumab (TCZ) versus TNF inhibitors (TNFi).1

RA is a chronic inflammatory disease that affects a person's joints, causing pain and disability. It can also affect internal organs. RA is more common in older people, but there is also a high prevalence in young adults, adolescents and even children, and it affects women more frequently than men.

Patients with RA have been shown to be at increased risk of developing certain malignancies, thought to be due to the immune dysregulation and/or chronic inflammation in RA. Recently, biologic DMARDs (bDMARDs) have become available and there are some concerns regarding malignancy with their use, given their target-specific inhibition of the immune system. However, there has been conflicting data regarding the influence of bDMARDs on malignancy.2

"The risk of malignancy among patients with RA has been of ongoing interest," said Professor Robert Landewé, Chairperson of the Scientific Programme Committee, EULAR. "With more biologic treatment options available and earlier initiation of therapy, it is important to understand the risk of malignancies in patients with RA."

This study examined the rate of incident malignancy, excluding NMSC, in patients with RA who were newly treated with either TCZ or TNFi.1

"Our study is one of a few to investigate head-to-head comparisons of malignancy risk between different types of biologics in RA," said Seoyoung C. Kim, MD, ScD, Associate Professor of Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, USA (study author). "This study found no difference in the risk of malignancy, excluding NMSC, in patients with RA who newly switched to TCZ versus TNFi from a different TNFi, abatacept or tofacitinib."

The study included adult patients with RA who had newly started on TCZ or a TNFi after failing on abatacept, tofacitinib or another TNFi. Investigators used three healthcare claims databases (Medicare, IMS ParMetrics Plus and Truven MarketScan) from 2010-2015 to identify 10,393 TCZ initiators who were propensity score matched (1:3 variable ratio) to 26,357 TNFi initiators. This is a statistical matching technique that controls for over 60 potential baseline confounding variables. Individuals were followed up until treatment discontinuation, outcome occurrence, disenrollment, death or the end of the study period.1

The primary outcome was an incidence of malignancy (excluding NMSC) which were identified based on two diagnosis codes within two months. The incidence of malignancy per 100 person-years ranged from 0.83 to 2.32 in TCZ patients, and from 0.96 to 2.15 in TNFi patients between the different databases. Statistical analysis revealed no significant differences between the groups. In addition, there were no significant differences in the incidence of the ten most frequently occurring cancers and leukaemia or human papilloma virus-related cancer which were analysed as individual secondary endpoints.1

Abstract number: OP0002
-end-
NOTES TO EDITORS

For further information on this study, or to request an interview with the study lead, please do not hesitate to contact the EULAR Press Office:

Email: eularpressoffice@ruderfinn.co.uk
Telephone: +44 (0) 20 7438 3084
Twitter: @EULAR_Press
YouTube: Eular Press Office

About Rheumatic and Musculoskeletal Diseases

Rheumatic and musculoskeletal diseases (RMDs) are a diverse group of diseases that commonly affect the joints but can affect any organ of the body. There are more than 200 different RMDs, affecting both children and adults. They are usually caused by problems of the immune system, inflammation, infections or gradual deterioration of joints, muscle and bones. Many of these diseases are long term and worsen over time. They are typically painful and Iimit function. In severe cases, RMDs can result in significant disability, having a major impact on both quality of life and life expectancy.3

About 'Don't Delay, Connect Today!'

'Don't Delay, Connect Today!' is a EULAR initiative that unites the voices of its three pillars, patient (PARE) organisations, scientific member societies and health professional associations - as well as its international network - with the goal of highlighting the importance of early diagnosis and access to treatment. In the European Union alone, over 120 million people are currently living with a rheumatic disease (RMD), with many cases undetected.4 The 'Don't Delay, Connect Today!' campaign aims to highlight that early diagnosis of RMDs and access to treatment can prevent further damage, and also reduce the burden on individual life and society as a whole.

About EULAR

The European League against Rheumatism (EULAR) is the European umbrella organisation representing scientific societies, health professional associations and organisations for people with RMDs. EULAR aims to reduce the burden of RMDs on individuals and society and to improve the treatment, prevention and rehabilitation of RMDs. To this end, EULAR fosters excellence in education and research in the field of rheumatology. It promotes the translation of research advances into daily care and fights for the recognition of the needs of people with RMDs by the EU institutions through advocacy action.

To find out more about the activities of EULAR, visit: http://www.eular.org.

References

1 Kim SC, Pawar A, Desai RJ, et al. No difference in the risk of malignancy in tocilizumab versus TNF inhibitor initiators in patients with rheumatoid arthritis: A multi-database cohort study. EULAR 2018; Amsterdam: Abstract OP0002.

2 Cho SK, Lee J, Han M, et al. The risk of malignancy and its incidence in early rheumatoid arthritis patients treated with biologic DMARDs. Arthritis Res Ther. 2017;19(1):277.

3 van der Heijde D, et al. Common language description of the term rheumatic and musculoskeletal diseases (RMDs) for use in communication with the lay public, healthcare providers and other stakeholders endorsed by the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR). Annals of the Rheumatic Diseases. 2018;doi:10.1136/annrheumdis-2017-212565. [Epub ahead of print].

4 EULAR. 10 things you should know about rheumatic diseases fact sheet. Available at: https://www.eular.org/myUploadData/files/10%20things%20on%20RD.pdf [Last accessed April 2018].

European League Against Rheumatism

Related Rheumatoid Arthritis Articles from Brightsurf:

Reducing dementia in patients with rheumatoid arthritis
The incidence of dementia in patients with rheumatoid arthritis is lower in patients receiving biologic or targeted synthetic disease modifying antirheumatic drugs (DMARDs) than in patients who receive conventional synthetic DMARDs, according to a new study.

Is rheumatoid arthritis two different diseases?
While disease activity improves over time for most rheumatoid arthritis (RA) patients, long-term outcomes only improve in RA patients with autoantibodies, according to a new study published this week in PLOS Medicine by Xanthe Matthijssen of Leiden University Medical Center, Netherlands, and colleagues.

Does the Mediterranean diet protect against rheumatoid arthritis?
Previous research has demonstrated a variety of health benefits associated with the Mediterranean diet, which is rich in olive oil, cereals, fruit and vegetables, fish, and a moderate amount of dairy, meat, and wine.

Reducing corticosteroid use in rheumatoid arthritis
Is the long-term use of glucocorticoids essential in people with chronic inflammatory diseases such as rheumatoid arthritis, or can early discontinuation prevent characteristic side effects?

Rheumatoid arthritis patients under treatment with methotrexate
Patients with rheumatoid arthritis (RA) often suffer from what is referred to as interstitial lung disease (ILD).

Rheumatoid arthritis -- can its onset be delayed or prevented?
Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disorder that leads to significant health issues as well as high treatment costs.

Disease burden in osteoarthritis is similar to rheumatoid arthritis
Osteoarthritis (OA) has traditionally been viewed as a highly prevalent but milder condition when compared with rheumatoid arthritis (RA), and some may believe that it is part of a normal aging process requiring acceptance, not treatment.

Prospect of a new treatment for rheumatoid arthritis
An international research group led by Charité -- Universitätsmedizin Berlin has completed testing a new drug to treat rheumatoid arthritis.

Can rare lymphocytes combat rheumatoid arthritis?
Immunologists at Friedrich-Alexander-Universität Erlangen-Nürnberg have demonstrated that ILC2, a group of rare lymphoid cells, play a key role in the development of inflammatory arthritis.

Rheumatoid arthritis meets precision medicine
Scientists are bringing precision medicine to rheumatoid arthritis for the first time by using genetic profiling of joint tissue to see which drugs will work for which patients, reports a new multi-site study.

Read More: Rheumatoid Arthritis News and Rheumatoid Arthritis Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.