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  • Malignant progression of precancerous lesions of the uterine cervix following biological DMARD therapy in patients with arthritis

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Malignant progression of precancerous lesions of the uterine cervix following biological DMARD therapy in patients with arthritis
  1. René Cordtz1,
  2. Lene Mellemkjær2,
  3. Bente Glintborg1,
  4. Merete Lund Hetland3,4,
  5. Lene Dreyer1
  1. 1Department of Rheumatology, Copenhagen University Hospital Gentofte, Hellerup, Denmark
  2. 2Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
  3. 3DANBIO Registry and Center for Rheumatology and Spine Diseases, Glostrup Hospital, Glostrup, Denmark
  4. 4Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Denmark
  1. Correspondence to René Lindholm Cordtz, Department of Rheumatology, Copenhagen University Hospital Gentofte, Entrance 5, 3rd floor, Kildegårdsvej 28, Hellerup 2900, Denmark; rcordtz{at}gmail.com

https://doi.org/10.1136/annrheumdis-2014-206909

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    Patients with rheumatoid arthritis (RA) are more frequent chronic carriers of high-risk human papilloma virus (HPV) strains compared with the background population—an important risk factor for developing cervical cancer—and patients with RA have an increased risk of high-grade cervical dysplasia (CD) and cervical cancer.1–3 Little is known about the safety of biological disease-modifying antirheumatic drug (bDMARD) treatment in arthritis patients with a history of premalignant lesions.

    We aimed to investigate how often female patients with inflammatory arthritis (RA, ankylosing spondylitis, psoriatic arthritis or other) and a history of premalignant lesions of the uterine cervix developed cervical cancer or another HPV-associated cancer according to ever versus never exposure to bDMARDs.

    The nationwide Danish DANBIO Registry started in 2000 and covers >90% of adults with rheumatological disease treated with bDMARDs in routine care.4 Since 2005, patients not treated with bDMARDs have also been registered. We linked 15 238 female patients identified in DANBIO …

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    Footnotes

    • Contributors LD conceived the study. LD, LM and RC designed the study. LD and LM acquired the data. RC performed the analysis. All authors contributed to the interpretation of data. RC drafted the manuscript and all authors revised the article critically for intellectual content and final approval of the article to be published. LD is the guarantor for the study.

    • Funding The Danish Rheumatism Association and Danish Cancer Society.

    • Competing interests None.

    • Ethics approval The project is entirely register based, and the patients have not been contacted. Therefore, no approval by the ethics committees was needed according to the Danish law. Approval by the Danish Data Protection Board Agency was obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.