Skin Cancer Risks with Biologic Medications

Skin cancer is the most common cancer in the United states with a one in five chance of being diagnosed during a persons’ lifetime” says Dr. Adam Mamelak, board certified Dermatologist and Mohs micrographic surgeon at Sanova Dermatology in Austin, Texas. Known risk factors include UV light exposure and genetic predisposition, however new evidence is shedding light on the increased risk of skin cancer in those taking immune suppressing and biologic medications such as tumor necrosis factor (TNF) inhibitors. These medications are used to treat a variety of autoimmune disorders including psoriasis and rheumatoid arthritis and work by impairing the body’s immune system. “Recent studies have shown that there may be an increased risk of skin cancer for those taking a biologic agent,” Dr. Mamelak says.

In 2011 the Journal of Dermatological Treatment published an article entitled “An Evidence-Based Review of Skin Cancer Rates on Biologic Therapies.” This particular study was a data review of nine large randomized controlled trials and meta-analyses. Of the nine studies reviewed, researches stated eight demonstrated increased risk for non-melamona skin cancers. The review also indicated the potential of even greater risk affecting psoriasis patients undergoing ultraviolet light therapies.

Another study, published in the British Medical Journal in 2013, looked at TNF inhibitors and the risk of malignant melanoma. The study focused only on those taking biologics for rheumatoid arthritis. The population study contained over 10,000 individuals in each comparison group. Researches discovered a 50% increase in the relative risk of invasive melanoma in patients treated with tumor necrosis factors for rheumatoid arthritis.

In 2016 the the same journal published another study demonstrating patients with rheumatoid arthritis appeared at greater risk for both squamous cell and basal cell carcinoma skin cancer, even without ever using a TNF inhibitor. However the study did illustrate a 30% increased risk of squamous cell in those treated with this biologic medication.

“Biologic medications are an extremely effective and targeted way of treating a number on inflammatory and autoimmune disorders,” Dr. Mamelak explains. “However, like all medications, there can be risks in taking them, and it is important to discuss all these issues with your physician prior to starting therapy.” Recent studies have suggested these medications may increase the risk of skin cancers including melanoma. Additional research and studies are required to further understand the relationship between biologics and skin cancer.

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