Malignancy development risk in psoriatic arthritis patients undergoing treatment: A systematic review and meta-analysis - ScienceDirect

https://www.sciencedirect.com/science/article/pii/S0049017218300672

Malignancy development risk in psoriatic arthritis patients undergoing treatment: A systematic review and meta-analysis

XuanLuo¹ChuiwenDeng¹YunyunFeiWenZhangYongzheLiXuanZhangYanZhaoXiaofengZengFengchunZhang

Abstract

Background

Psoriatic arthritis (PsA) is a chronic and seronegative inflammatory arthritis occurring in patients with psoriasis. The current knowledge about the risk of malignancy associated with psoriatic arthritis (PsA) patients undergoing therapy is controversial. We focused on the relationship between malignancy and therapy and undertook a meta-analysis to address this issue.

Methods

A systematic literature search of the PubMed, EMBASE, and Web of Science databases was performed to identify relevant studies and trials. Statistical analysis was conducted using STATA 11.2 software.

Results

Nine cohort studies were included, corresponding to a total of 43,115 PsA patients undergoing therapy. A significant positive association between therapy and increased risk for overall malignancy was found relative to the general population as the reference group (pooled RR, 1.29; 95% CI, 1.04–1.60). High heterogeneity was found (I² = 71.37%). Subgroup analysis reported that PsA patients treated with conventional synthetic disease modifying antirheumatic drugs (csDMARDs) presented increased cancer risk (pooled RR, 1.75; 95%CI, 1.40 to 2.18) but patients treated with biological disease modifying antirheumatic drugs (bDMARDs) did not (pooled RR, 0.957; 95%CI, 0.80 to 1.14). Compared to controls, patients with PsA undergoing treatment specifically are at increased risk for non-melanoma skin cancers (pooled RR, 2.46; 95%CI, 1.84 to 3.28).

Conclusions

This study allowed the estimation of cancer risk in PsA patients during therapy. Large-scale longitudinal studies will be essential to draw firm conclusions regarding PsA-associated risk for treatment-induced malignancy.

Keywords

psoriatic arthritis

Cancer risk

Conventional synthetic disease modifying antirheumatic drugs

Risk factor

Meta-analysis

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¹

These authors are the co-first authors on this study.

© 2018 Elsevier Inc. All rights reserved.

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Benjamin Hidalgo-Matlock

Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 2224-0654

Momentum Escazu: 2101-9574

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