In the first three years following the diagnosis of colorectal cancer, lung or prostate, the survival of patients with rheumatoid arthritis (PR) treated with anti-TNF (tumor necrosis factor) was not reduced compared to that of patients treated by a conventional synthetic background treatment (CSDMard for conventional synthetic disease-modifying antirheumatic drugs) or not treated by Dmard, according to a new study published in The Lancet Rheumatology.
The same team, from the University of Texas, had already shown that the patients PR treated with anti-TNF and with breast cancer were not exposed to a death surrisque at 2 years. Also the authors conclude that the possibility “To continue or start treatment with anti-TNF” for PA patients with one of these cancers at an early stage. However, they recommended “Additional research to determine the safety of anti-TNFs when used for more than three years or in patients with other types of cancer.”
Anti-TNFs are organic Dmard (BDMARD) whose immunosuppressive activity could alter the tumor immunity of patients thus treated and affect the risk of cancer or its progression. In addition, PR patients have been shown naturally more at risk of cancers, especially lymphomas. The health agencies had included in the summary of the characteristics of these products a warning it.
-While clinical trials and major recent observation studies do not show cancer overflowing in anti-TNF patients, these biotherapies could have a deleterious effect on the progression and recurrence of cancer in patients already with a malignant tumor.
Less good survival with glucocorticoids
Researchers have included patients aged 66 and more affected by PR in whom colorectal cancer (n = 514), lung (n = 864) or prostate (n = 603) was diagnosed between 1is January 2008 and December 31, 2019. Patients had taken, during the year following the diagnosis of cancer, either treatment with anti-TNF, either by CSDMARD, or no DMARD. In total, 16 % of patients with colorectal cancer took anti-TNF with or without CSDMard, 12 % in lung cancer and 20 % in prostate cancer.
“No significant deleterious association has been observed for overall or specific survival by cancer regardless of cancer and whatever the moment of analysis (one, two and three years old, editor’s note)”, “, conclude the authors. On the other hand, patients who received glucocorticoids during the first year had global survival and specificly lower cancer than those who had not received and, for the three cancers.
