#3-20E. Reassuring Real-World Data: Cancer Risk with b/tsDMARDs in RA (Rheumatology, 2025)

Do JAK inhibitors and other targeted therapies truly increase cancer risk in routine clinical practice? Addressing the persistent safety concerns exacerbated by the ORAL Surveillance trial, this episode examines a significant study from the Spanish BIOBADASER III registry. Researchers analyzed longitudinal data from 2000 to 2023 to compare malignancy incidence in rheumatoid arthritis patients treated with biologic and targeted synthetic DMARDs against those receiving TNF inhibitors. The most pivotal finding is that the study found no statistically significant increase in the risk of overall cancer or non-melanoma skin cancer for patients on JAK inhibitors, IL-6 inhibitors, or abatacept compared to TNFi, a reassuring trend that persisted even when analyzing subgroups with high cardiovascular risk. However, while these results support the safety of JAK inhibitors in a real-world setting, listeners must critically appraise the study's observational nature, which subjects it to indication bias, and note the absence of a b/tsDMARD-naive control group. For clinicians, this paper provides essential evidence to balance against clinical trial warnings, facilitating more nuanced risk-benefit discussions during therapeutic selection.

Citation: Molina-Collada J, Otero-Varela L, Vela P, et al. Cancer risk in patients with rheumatoid arthritis receiving biologic and targeted synthetic disease-modifying antirheumatic drugs: results from the BIOBADASER III registry. Rheumatology. 2025. DOI: 10.1093/rheumatology/keaf556

Disclaimer: This audio summary is based on personal interpretation and does not guarantee the exact content of the original paper. Please refer to the original article for details.