Clinically important increases in melanoma risk in patients treated with biologic therapy for common inflammatory diseases cannot be ruled out based on current evidence, according to a review published online May 20 in JAMA Dermatology.
Shamarke Esse, from the University of Manchester in the United Kingdom, and colleagues conducted a systematic literature search to identify studies quantifying the risk for melanoma in biologic-treated patients with inflammatory bowel disease, rheumatoid arthritis, and psoriasis compared to patients treated with conventional systemic therapy.
Based on seven studies (34,029 biologic-treated patients and 135,370 biologic-naive patients treated with conventional systemic therapy), the researchers found that biologic treatment was positively associated with nonsignificant increases in melanoma among patients with inflammatory bowel disease (pooled relative risk, 1.20; 95 percent confidence interval, 0.60 to 2.40), rheumatoid arthritis (pooled relative risk, 1.20; 95 percent confidence interval, 0.83 to 1.74), or psoriasis (hazard ratio, 1.57; 95 percent confidence interval, 0.61 to 4.09) versus those who received conventional systemic therapy. Most studies did not adjust for other risk factors.
“Further studies with large patient numbers that adjust for key risk factors are needed to resolve the issue of long-term safety of biologic therapy,” the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.