title: [Medication treatment of rheumatoid arthritis with a history of malignancy. Epidemiological data].
abstract: BACKGROUND
  Only insufficient data are available regarding the question whether treatment with immunosuppressants or biologicals is feasible and safe in patients with a history of malignancy.
  
  
  METHODS
  Literature search via PubMed, EULAR abstracts and ACR abstracts from 2013 to 2015.
  
  
  RESULTS
  The Société Francaise de Rhumatologie, the Canadian Rheumatology Association and the American College of Rheumatology have tried to make recommendations on this topic. Direct evidence mainly originates from data in three national registries which suggest that treatment with tumor necrosis factor (TNF) inhibitors and rituximab appears to be safe for carefully selected patients, at least if there is a longer interval between treatment with biologicals and oncological treatment. Furthermore, despite partly conflicting data all routine drugs for treating rheumatoid arthritis do not seem to show a consistently increased risk of de novo malignancies. The currently available data are presented for each drug of interest.
  
  
  CONCLUSIONS
  Taking the current literature into account an attempt is made to formulate an algorithm for the medicinal treatment of patients with rheumatoid arthritis and a history of malignancy.
authors.affiliation: Rheumatologie/klinische Immunologie, Medizinische Klinik und Poliklinik 2, Zentrum Innere Medizin, Universitätsklinikum Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland. schmalzing_m@ukw.de.
authors.forename: M
authors.initials: M
authors.lastname: Schmalzing
authors.affiliation: Programmbereich Epidemiologie, Gruppe Pharmakoepidemiologie, DRFZ - Deutsches Rheuma-Forschungszentrum, Charitéplatz 1, 10117, Berlin, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Strangfeld
authors.affiliation: Rheumatologie/klinische Immunologie, Medizinische Klinik und Poliklinik 2, Zentrum Innere Medizin, Universitätsklinikum Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland.
authors.forename: H-P
authors.initials: HP
authors.lastname: Tony
mesh_terms: D000465:Algorithms; D018501:Antirheumatic Agents / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000453:epidemiology*; D002170:Canada / Q000453:epidemiology; D015897:Comorbidity; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000517:prevention & control*; D019317:Evidence-Based Medicine; D006801:Humans; D009369:Neoplasms / Q000453:epidemiology* / Q000517:prevention & control*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D018501:Antirheumatic Agents
keywords: Biologics; Immunosuppression; Registries; Rituximab; TNF inhibitors