title: [Disease-modifying antirheumatic drugs in rheumatoid arthritis patients with a history of colorectal cancer].
abstract: BACKGROUND
  Cells of the adaptive immune system are relevant for the anti-tumor immune response; therefore, the basal therapy with disease-modifying antirheumatic drugs (DMARD) in rheumatoid arthritis patients with a history of gastrointestinal cancer must be carefully considered.
  
  
  OBJECTIVE
  This article presents the evidence regarding colorectal cancer (CRC) and rheumatoid arthritis.
  
  
  RESULTS
  The article is based on a PubMed search as well as a search in congress abstracts of the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR). Current recommendations regarding screening and follow-up of CRC are summarized for clinically active rheumatologists. The current status of therapy and future therapeutic options are presented. The lower incidence of CRC in rheumatoid arthritis (RA) patients and the incidence under treatment with various DMARDs are described. The treatment options for RA patients in different tumor situations, e.g. during cytostatic therapy, palliative and curative situations are discussed, as well as the available evidence. In spite of the unsatisfactory level of evidence, conclusions and practical considerations for use by rheumatologists in clinical practice are discussed.
authors.affiliation: Rheumatologische Schwerpunktpraxis, Praxisgemeinschaft Rheumatologie - Nephrologie, Erlangen, Deutschland. Kleinert_S@klinik.uni-wuerzburg.de.
authors.forename: S
authors.initials: S
authors.lastname: Kleinert
authors.affiliation: Medizinische Klinik 1, Universitätsklinikum Erlangen, Erlangen, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Waldner
authors.affiliation: Rheumatologische Schwerpunktpraxis, Praxisgemeinschaft Rheumatologie - Nephrologie, Erlangen, Deutschland.
authors.forename: J
authors.initials: J
authors.lastname: Wendler
authors.affiliation: Medizinische Klinik und Poliklinik II, Schwerpunkt Medizinische Onkologie, Würzburg, Deutschland.
authors.forename: V
authors.initials: V
authors.lastname: Kunzmann
mesh_terms: D000465:Algorithms; D018501:Antirheumatic Agents / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000453:epidemiology*; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000517:prevention & control*; D015897:Comorbidity; D004334:Drug Administration Schedule; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000517:prevention & control*; D005060:Europe; D019317:Evidence-Based Medicine; D006801:Humans; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States
chemical_list: D018501:Antirheumatic Agents
keywords: Biologicals; Colorectal cancer; Disease-modifying antirheumatic drugs; Immunosuppression; Tumor