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We read with interest the report by Mercer et al in the February 2017 issue of ARD1 which examined the risk of invasive melanoma in patients with rheumatoid arthritis (RA) treated with biologics. In a collaborative analysis of data from nine European countries (11 biologics registers), the authors report a pooled standardised incidence ratio (SIR) for tumour necrosis factor inhibitor (TNFi)-exposed patients of 1.2 (95% CI 0.99 to 1.6) compared with the general population (country specific) and an incidence rate ratio (IRR) of 1.1 (0.8–1.6) for TNFi-exposed patients compared with biologic naive patients. While they allowed that an increased melanoma risk in patients with RA treated with TNFi could not …
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