期刊
RHEUMATOLOGY AND THERAPY
卷 4, 期 2, 页码 333-347出版社
SPRINGER
DOI: 10.1007/s40744-017-0064-4
关键词
Cancer; Comorbidity; Inflammation; Malignancy; Rheumatoid arthritis
类别
资金
- National Institutes of General Medical Sciences [T32-GM-65841]
- Mayo Clinic College of Medicine's Medical Scientist Training Program
Traditional and biologic disease-modifying antirheumatic drugs (DMARDs) are effective medications for the management of rheumatoid arthritis (RA). However, the effects of these medications on immune function raises concern that they may increase long-term cancer risk. The baseline risk for some cancers appears to differ in patients with RA compared to the general population, with the former having an increased risk of lymphoma, lung cancer and renal cancer, but a decreased risk of colorectal and breast cancer. Some DMARDs appear to increase the rate of specific cancer types (such as bladder cancer with cyclophosphamide), but few appear to increase the overall cancer risk. Studying the link between lymphoma and disease severity in RA is complicated because patients with persistently active disease are at increased risk for lymphoma, and disease severity correlates with more intense use of immunosuppressive medications. Overall, cancer risk in patients with RA is slightly above that of the general population, with the increased risk likely secondary to an increased risk of lymphomas in those with high disease activity. Risk mitigation includes management of RA disease activity as well as age- and sex-appropriate cancer screening.
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