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• W2003669896 abstract "Objective: There have been some concerns surrounding a possible association between Rheumatoid Arthritis (RA), malignancies and the use of biologic response modifiers (BRM). The risk of malignancy seems to be related to the degree and duration of inflammation in RA patients and increased age appears to be an additional risk factor. A decade after the introduction of BRM we analyzed our patients with RA under BRM to assess the prevalence of neoplasias and the need for better screening processes, by comparing patients with RA and neoplasia under BRM therapies with those with neoplasia under traditional disease-modifying antirheumatic drugs. Methods: The authors made a retrospective observational study, by reviewing the files of all patients (pts) with neoplasia and RA in the Autoimmune Diseases Unit. Pts were analyzed according to gender, age, seropositive RA, DAS28, mean disease duration, use of BMR, type and onset of primary malignancy. Results: Of the n = 155 pts with RA, n = 57 were receiving a biological agent. Of these n = 38 pts were female, with an average age of 55.37 years, a mean disease duration of 9.35 years and mean duration of BMR use of 3.6 years. The mean DAS28 was 5.9 and after BMR use 3.1. The n = 6 pts with neoplasia had an average age of 67.33 years (only n = 1 pt <65 years), a mean disease duration of 11.83 years; a mean duration of BMR use of 5.2 years (etanercept n = 3 pts, rituximab n = 2 pts and adalimumab n = 1 pt). The mean DAS28 was 5.3 and after BMR use 3.0. Neoplasia onset was previous to the use of a BMR in n = 2 pts (12 and 15 years), of which ovary n = 1 pt, breast and cervix n = 1 pt, there were no recurrences; in n = 4 pts the neoplasia occurred after the use of BMR (3, 4, 5 and 7 years), of which skin n = 2, breast n = 1 and prostate n = 1. None of the pts died, but n = 1 suspended BMR. Of the n = 108 pts under traditional DMARDs, n = 13 had the diagnosis of malignant disease with the mean age of 61.54 years and n = 6 of them had it before the diagnosis of RA. The remaining n = 7 had the diagnosis of neoplasia a mean of 11.43 years after the diagnosis of RA. The types of primary neoplasia were gynecological n = 4, gastrointestinal tract n = 3, breast n = 2, leukemia n = 1, lung n = 1, kidney n = 1 and prostate n = 1. Conclusions: In our sample, the pts with malignancy were older, with a longer mean duration of a BMR use and similar DAS28 to all of the pts with RA. However, pts with RA without BMR have a lower age of onset and the distribution between the types of primary neoplasia is slightly different, which might be explained by the therapy's antiinflammatory effects in some malignancies vs. immunosuppression in others." @default.
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• W2003669896 date "2013-10-01" @default.
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• W2003669896 title "Neoplasia in rheumatoid arthritis patients using a biological agent in an autoimmune diseases unit" @default.
• W2003669896 doi "https://doi.org/10.1016/j.ejim.2013.08.317" @default.
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