Recommendations address balancing treatment risks for inflammatory arthritis and cancer

Several autoimmune or inflammatory diseases are known to be associated with an increased cancer risk. In some people, this can be directly due to underlying inflammation or autoimmunity. For others, it could be due to comorbidities or shared risk factors between inflammatory arthritis and some types of cancer.

Understandably, people who have had cancer in the past may be reluctant to receive therapy that could increase their chances of the cancer coming back. However, there are also inherent risks to leaving inflammatory arthritis untreated. To address this, EULAR has put together a new set of points to consider.

The new work, published in the December 2024 issue of the Annals of the Rheumatic Diseases, includes five overarching principles and eight individual points to consider. The principles stress that this new guidance should be used alongside the main EULAR recommendations for each specific type of inflammatory arthritis and note that both new and recurrent cancers can occur in people with inflammatory arthritis who have had cancer in the past.

It is important that each person's individual risk of cancer recurrence is assessed based on their medical history and their underlying disease. Ultimately, the treating rheumatologist is responsible for managing inflammatory arthritis, regardless of whether people have had cancer in the past. All treatment should try to achieve the best possible outcomes for the disease, but must be based on a shared decision between the patient, their rheumatologist, and their oncology team.

EULAR hopes that the new publication will provide guidance for clinical practice, and help health care teams to manage targeted therapies in people with inflammatory arthritis and a previous malignancy. The points should also help to manage treatment decisions between different health care teams, ensuring all risks and benefits are considered.

More information:
Eden Sebbag et al, 2024 EULAR points to consider on the initiation of targeted therapies in patients with inflammatory arthritis and a history of cancer, Annals of the Rheumatic Diseases (2024). DOI: 10.1136/ard-2024-225982. ard.bmj.com/content/early/2024 … 2/20/ard-2024-225982

Provided by European Alliance of Associations for Rheumatology (EULAR)