American College of Rheumatology Releases Rheumatoid Arthritis Treatment Guidelines for Patients with Cancer
The ACR 2015 Rheumatoid Arthritis (RA) treatment guidelines were published after nearly a year of review and revision by the panel. The guideline committee recommends that individuals with RA and cancer be treated in the following manner:
Previous Melanoma and Non-Melanoma Skin Cancer: Established RA patients with moderate or high disease activity and a history of previously treated or untreated skin cancer (melanoma or non-melanoma) are conditionally recommended to be treated with disease modifying anti-rheumatic drug (DMARD) therapy over biologics or tofacitinib.
Previous Lymphoproliferative Disorders: Established RA patients with moderate or high disease activity and a history of a previously treated lymphoproliferative disorder are strongly recommended to be treated with rituximab, rather than a TNFi and conditionally recommended to be treated with combination DMARD therapy, abatacept or tocilizumab rather than TNFi.
Previous Solid Organ Cancer: Established RA patients with moderate or high disease activity and a previously treated solid organ cancer are conditionally recommended to be treated for RA just as one would treat an RA patient without a history of solid organ cancer.
Source: American College of Rheumatology press release. 2015 ACR Guideline for the Treatment of Rheumatoid Arthritis Now Available Online. Nov. 10, 2015.