Treatment of Autoimmune Rheumatic Disease and the Risk of Malignancy

The association between rheumatic disease and cancer stems from systemic inflammation and immune dysregulation leading to malignancy. In addition, many immunosuppressive therapies have been used in the treatment of these conditions with varying results regarding the risk of malignancy. In this review, we first discuss the risk of cancer inherent to rheumatic diseases themselves. In the second part of the review, we explore recent data reporting the cancer risk of immunosuppressive medications used in the treatment of rheumatic disease.

Longitudinal and population-based safety studies have recently shown that most agents used in the treatment of rheumatic disease are not linked to an increased cancer risk compared to the general population with the exception of non-melanoma skin cancers.

The majority of medications used to treat rheumatic disease do not appear to have a clear increased risk of malignancy. However, the inability to fully parse the cancer risk conferred by the rheumatic disease itself, its cumulative disease activity, and the medications used in its treatment warrants continued study. In addition, long-term data (> 10 years) and studies on commonly used combination therapies are needed to better understand this area.