A question Rheumatologists have had for the last several years is whether the newer medications for rheumatoid arthritis are truly safe to use long term. A recent article in JAMA looks at this question in regards to cancer risk. Looking at 63 high quality studies this meta analysis comes to the conclusion that cancer risk is not higher in RA patients using a biologic medication. Biologics are newer medications that have been out for the last 15 years. In the past there was concern that lymphoma and skin cancer risk may be slightly higher if you use a biologic medication. It’s reassuring to note that with time it seems that these medications overall do not increase cancer risk.
Of course, there is a large difference between theoretical risk and the risk an individual may have. If someone already has a history of cancer, risk assessment must be viewed more cautiously for that person. If someone has a family history of cancer or has other additional risk factors such as smoking, specific genes that put them at risk, or other variables, again the risk assessment will be different than the risk in a general population. Also consider that I’m only referring to cancer risk, and of course there are potential issues involving infections, and these meds may not be appropriate in individuals with certain heart, kidney, or neurologic problems. I think the take away from this large analysis is that the biological medications are great for Rheumatoid Arthritis patients, have well defined risks, and have now also been shown again to pose no additional cancer risk in those individuals who do not already have a higher risk of developing cancer.