The short answer to that question is “we don’t really know yet.” But the more important question to ask yourself is “What is the potential risk compared with the potential benefit? Am I willing to take that risk?"
In the September issue of Arthritis & Rheumatism, Frederic Wolfe, MD, of National Data Bank for Rheumatic Diseases and University of Kansas School of Medicine, Wichita, and Kaleb Michaud, PhD, of the University of Nebraska Medical Center in Omaha, presented results of a study indicating an increased risk of skin cancer in people receiving biologic therapy. Using data from more than 13,000 people with rheumatoid arthritis, they determined that biologic therapy is associated with increased risk for both melanoma and non-melanoma skin cancers, but not for solid tumors, lymphomas or leukemias. These associations were consistent across different biologic therapies.
This is in contrast to a study published in March of this year that showed the rate of cancer was not increased in those with inflammatory arthritis compared with the general population of Norfolk, United Kingdom. Of note, however, this study excluded non-melanoma skin cancers from their data collection. Although the rate of cancer was not increased, it was found that after adjusting for age, sex and site of cancer, patients with inflammatory arthritis had a 40 percent increased risk of dying compared with the general Norfolk population with cancer.
Daniel Solomon, MD, MPH, and Soko Setoguchi, MD, DrPH, of Brigham and Women’s Hospital and Harvard Medical School in Boston, using an Arthritis Foundation research grant, studied the risk of developing cancer in people with RA who take tumor necrosis factor alpha (TNF-α) medications. They found that people taking anti-TNF-α drugs had no greater risk of developing cancer than people taking methotrexate. Of the mortality findings presented in March, Dr. Solomon commented that “It would further our understanding of both RA and cancer if we could better understand the relationship between these two disease processes. It is clear that recognizing the increased mortality risk is an important step, but much work remains to be done to uncover the reasons behind the increased risk so preventive action can be taken.”
Dr. Wolfe, when asked by WebMD about the importance of his study, said, "If there is a real message in these studies, it is that the overall risk of cancer is small in rheumatoid arthritis patients. The overall effect is to say things are much the same as they have been over the last several decades. That is reassuring with these new drugs. ... I don't think people should be concerned. It may be these drugs turn out to be safe. It looks as though they are, and I am not particularly worried."