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    Therapy with Biologic Agents After Diagnosis of Solid Malignancies: Results from the Corrona Registry

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    Authors
    Pappas, Dimitrios A.
    Rebello, Sabrina
    Liu, Mei
    Schenfeld, Jennifer
    Li, Youfu
    Collier, David H.
    Accortt, Neil A.
    UMass Chan Affiliations
    Department of Emergency Medicine
    Document Type
    Journal Article
    Publication Date
    2019-11-01
    Keywords
    biologics
    malignancy
    rheumatoid arthritis
    Analytical, Diagnostic and Therapeutic Techniques and Equipment
    Immune System Diseases
    Musculoskeletal Diseases
    Neoplasms
    Rheumatology
    Skin and Connective Tissue Diseases
    
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    Link to Full Text
    https://doi.org/10.3899/jrheum.171457
    Abstract
    OBJECTIVE: Guidelines suggest that rheumatoid arthritis (RA) patients with previously treated solid malignancy may be treated as patients without such history. The recommendation is based on limited evidence, and rheumatologists and patients are frequently hesitant to start or continue biologic therapy after a cancer diagnosis. The objective of this study was to describe biologic use in real-world patients with RA following a malignancy diagnosis. METHODS: RA patients enrolled in the Corrona registry and diagnosed with solid malignancy with at least 1 followup visit within 12 months after diagnosis were included in this analysis. The proportion of patients continuing or initiating biological/targeted synthetic disease-modifying antirheumatic drug (bDMARD/tsDMARD) after diagnosis was estimated. Median time to initiation of bDMARD/tsDMARD after diagnosis was calculated using the Kaplan-Meier method and the proportion initiating biologic treatment in 6-month time intervals was estimated using the life-table method. RESULTS: There were 880 patients who met inclusion criteria with 2585 person-years total followup time postdiagnosis. Of those, 367 (41.7%) were treated with bDMARD/tsDMARD within 12 months preceding malignancy, of whom 270 (30.7%) were taking such agents at first postdiagnosis visit. Forty-four (5%) switched biologic agents within 36 months and an additional 90 patients (10.2%) started a biologic. The majority of bDMARD/tsDMARD initiations during followup was a tumor necrosis factor inhibitor (TNFi; 53.5%). CONCLUSION: In real-world practice, nearly one-third of RA patients with a cancer diagnosis were treated with systemic therapy in the immediate visit after malignancy diagnosis and a considerable percentage of malignancy survivors initiated biologic therapy within 3 years. The majority of bDMARD/tsDMARD initiations post-malignancy diagnosis was a TNFi.
    Source

    J Rheumatol. 2019 Nov;46(11):1438-1444. doi: 10.3899/jrheum.171457. Epub 2019 Apr 1. Link to article on publisher's site

    DOI
    10.3899/jrheum.171457
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/41275
    PubMed ID
    30936285
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    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.3899/jrheum.171457
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    UMass Chan Faculty and Researcher Publications
    Emergency Medicine Publications

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