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The following is a summary of “Cancer risk with tocilizumab/sarilumab, abatacept and rituximab treatment in patients with rheumatoid arthritis: a Danish cohort study,” published in the March 2025 issue of Rheumatology by Westermann et al. 

Researchers conducted a retrospective study to compare cancer risk in patients with RA treated with tocilizumab/sarilumab, abatacept, or rituximab against those receiving TNF inhibitors (TNFi) and biological DMARDs (bDMARD)-naïve.  

They conducted a nationwide registry-based cohort study of patients with RA initiating bDMARD treatment with tocilizumab/sarilumab, abatacept, rituximab, or TNFi, and patients with bDMARD-naïve starting their second conventional synthetic DMARD. Patients were identified in Danish Rheumatology Quality Register (DANBIO) and followed for cancer from 2006 to 2020. Person-years, deaths, and cancers were allocated to each treatment group using a ‘latest type of treatment’ approach. Inverse probability of treatment weighting and weighted cause-specific Cox models calculated hazard ratios (HRs) for cancer in each treatment group compared with TNFi-treated and bDMARD-naïve groups. 

The results showed 21,982 treatment initiations, 96,475 person-years, and 1,423 cancers. No statistically significant increased HRs were found for overall cancer in tocilizumab/sarilumab, abatacept, or rituximab groups (HRs 0.7–1.1). Abatacept use for over 5 years showed a non-significant increase vs. TNFi (HR 1.41, 95% CI 0.74–2.71). Rituximab showed non-significantly reduced HRs for hematological cancers vs. TNFi (HR 0.09, 95% CI 0.00–2.06) and bDMARD-naïve (HR 0.13, 95% CI 0.00–1.89). 

Investigators found no increased cancer risk in patients with RA treated with tocilizumab/sarilumab, abatacept, or rituximab compared with TNFi-treated and patients with bDMARD-naïve in a real-world setting. 

 Source: academic.oup.com/rheumatology/article/64/3/1019/7624156