A bird eye view on cancer comorbidities in rheumatoid arthritis patients: an underestimated incidences and possible preventive treatments

Rheumatoid arthritis (RA) is a most common autoimmune disorder in which the patients’ body fights with itself. It affects multiple joints leading to cartilage erosion and joint deformity which put heavy burden on the economic condition of patients’ family as well as on the economy of the country. The objective of this review was to find the overall increased incidences of lymphomas associated with RA in general population undergoing treatment by commonly used cancer drugs. The comorbidities associated with the use of biologics are lesser in number than synthetic disease-modifying antirheumatic drugs. Methotrexate shows an almost 200% increase in melanoma, 400% increase in non-Hodgkin’s lymphoma and 200% increase in lung cancer cases. Leflunomide and cyclophosphamide have also shown approximately 200% increase in pancreatic and lymphoma incidences, respectively. The biologics which act as disease-modifying antirheumatic drugs like rituximab and tocilizumab have shown negligible increase in cancer incidences in RA patients except nonmelanoma skin cancer for rituximab. Hence, it is suggested to boost the use of rituximab and tocilizumab either alone or in combination with vismodegib to reduce the risk of nonmelanoma skin cancer and non-Hodgkin’s lymphoma.