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We read with interest the report by Mercer et al in the February 2017 issue of ARD 1 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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