Zeitschrift für Rheumatologie

, Volume 69, Issue 9, pp 774–779

The risk of malignancies in RA patients treated with biologics

Leitthema

Abstract

Ever since biologics were introduced in the treatment of RA around 10 years ago, concerns about their safety profiles, including cancer, have been raised. In the case of cancer, these concerns are based on our incomplete understanding of the full effects of these drugs, or the pathways that they inhibit, and their relation to cancer. Thus, it has been difficult to formulate specific hypotheses regarding what to expect (Which cancer types? In which patients? When?), and it will take time until we feel confident that all relevant risks are well characterized. Through RCT meta-analyses and observational studies including the biologics registers, some data have emerged. So far, but with exceptions both in terms of risks observed and absence of data, the emerging picture is reassuring rather than alarming.

Keywords

Rheumatoid arthritis Cancer Biological drugs Cohort studies Registries 

Malignomrisiko bei Patienten mit rheumatoider Arthritis nach Therapie mit Biologika

Zusammenfassung

Seit Einführung von Biologika in die Therapie der rheumatoiden Arthritis vor etwa 10 Jahren sind Bedenken hinsichtlich ihres Sicherheitsprofils, einschließlich Malignomen, erhoben worden. Dabei basieren diese Bedenken auf dem unvollständigen Verständnis der gesamten Wirkungen dieser Präparate bzw. der Signalwege, die sie hemmen, und ihrer Beziehung zu Malignomen. Folglich ist es schwierig, bestimmte Hypothesen im Hinblick auf das zu formulieren, was zu erwarten ist (Welche Krebsarten? Bei welchen Patienten? Wann?), und es braucht Zeit, bis wir überzeugt sind, dass alle relevanten Risiken ausreichend beschrieben wurden. Einige Daten konnten durch Metaanalysen von randomisierten kontrollierten Studien und Beobachtungsstudien einschließlich der Biologika-Register schon erhoben werden. Bisher ist das sich abzeichnende Bild eher ermutigend als alarmierend, mit Ausnahmen hinsichtlich beobachteter Risiken und fehlender Daten.

Schlüsselwörter

Rheumatoide Arthritis Malignome Biologische Präparate Kohortenstudien Register 

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Clinical Epidemiology Unit T2:01, Department of Medicine Solna, Karolinska Institutet, and Department of RheumatologyKarolinska University Hospital SolnaStockholmSchweden

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