Reumatizam, Vol. 62 No. suppl. 1, 2015.
Review article
TREATMENT OF RHEUMATIC DISEASES AND MALIGNANCY
Srdjan Novak
Abstract
Although chronic inflammation has pro-tumorigenic effects,
it is well known that immunosuppressive drugs may
increase the risk for certain tumors. Methotrexate, the drug
of choice in many rheumatic disases, is usually considered
as a drug with low oncogenic potential. However, some recent
studies which deserve to be confirmed on a larger number
of patients, showed that the use of methotrexate carries
a higer risk for malignant disease in comparison with TNF
inhibitors and other disease-modifying drugs. Meta-analyses
and data from registries of rheumatic patients showed
that TNF inhibitors are not associated with a higher risk fornon-melanoma and melanoma skin tumors. Most guidelines
agree that biologics can be started if the malignant disease
was cured five or more years previously, but the biology
of the tumor has to be taken into account as well. Recent
data showed that particular caution is needed in patients
with a history of melanoma. It seems that rituximab is the
drug of choice in patients with a history of malignant disease
treated within less than five years, as well as in patients
with treated lymphoproliferative disorders.
lymphomas and solid malignomas, but that a risk exists for
Keywords
malignancy; methotrexate; rituximab; TNF inhibitors
Hrčak ID:
182789
URI
Publication date:
10.10.2015.
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