OP0045 EULAR POINTS TO CONSIDER ON THE INITIATION OF TARGETED THERAPIES IN PATIENTS WITH INFLAMMATORY ARTHRITIDES AND A HISTORY OF CANCER

E. Sebbag; K. Lauper; J. Molina Collada; D. Aletaha; Johan Askling; K. Benesova; H. Bertheussen; S. Bitoun; E. C. Bolek; G. R. Burmester; Helena M. Canhão; K. Chatzidionysiou; J. Curtis; F. X. Danlos; V. Guimaraes; M. L. Hetland; Florenzo Iannone; M. Kostine; T. W. Kragstrup; T. K. Kvien; A. Regierer; H. Schulze-Koops; L. Silva-Fernández; Z. Szekanecz; M. H. Buch; A. Finckh; J. E. Gottenberg

doi:10.1136/annrheumdis-2023-eular.4789

OP0045 EULAR POINTS TO CONSIDER ON THE INITIATION OF TARGETED THERAPIES IN PATIENTS WITH INFLAMMATORY ARTHRITIDES AND A HISTORY OF CANCER

E. Sebbag, K. Lauper, J. Molina Collada, D. Aletaha, Johan Askling, K. Benesova, H. Bertheussen, S. Bitoun, E. C. Bolek, G. R. Burmester, Helena M. Canhão, K. Chatzidionysiou, J. Curtis, F. X. Danlos, V. Guimaraes, M. L. Hetland, Florenzo Iannone, M. Kostine, T. W. Kragstrup, T. K. KvienA. Regierer, H. Schulze-Koops, L. Silva-Fernández, Z. Szekanecz, M. H. Buch, A. Finckh, J. E. Gottenberg

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Konferenceabstrakt i tidsskrift › Forskning › peer review

Abstract

Background Potential associations between targeted therapies and a new cancer in patients with an inflammatory arthritis (IA) and a history of malignant disease are a frequent concern in daily rheumatology practice. IA and/or immunomodulatory drugs might confer a specific risk of malignancy. No evidence-based framework has been proposed to guide clinicians on the benefit/risk balance when initiating or reinitiating a targeted therapy (bDMARDs/tsDMARDs) in this context.Objectives This initiative aimed to develop points to consider (PTC) to assist rheumatologists.when initiating/reinitiating a targeted therapy in the context of a previous malignancy.Methods Following EULAR standardised operating procedures, a task force of 2 patient representatives.and 25 experts (comprising 2 methodologists, 2 EMEUNET members, 1 oncologist.and 20 rheumatologists) first met to define the research questions for a systematic literature review concerning patients with IA and a history of cancer and other relevant information for consideration including: incidence of cancer in targeted therapy-treated patients and no history of cancer, translational research in onco-rheumatology, management with targeted therapy of immune-related adverse events of checkpoint inhibitors. In a second meeting, the task force formulated.the overarching principles and the PTC.Results The group formulated 5 overarching principles and 8 PTC relevant to the initiation of targeted therapies in patients with IA and a history of cancer. Major themes included a) the need to assess.the individualized risk of cancer recurrence based on the characteristics of the patient, the cancer and the underlying disease; b) the importance of engaging with specialists caring for the cancer and.to define treatment based on a shared decision between the patient and the rheumatologist;c) the possibility to initiate without delay an appropriate targeted therapy for the treatment of.the IA in patients in remission of their cancer; d) the proposal to prefer anti-cytokine bDMARDs.over other treatment options in patients with history of solid cancer and to prefer.B cell depleting therapy in patients with a history of lymphoma; e) the proposal to use JAK inhibitors and abatacept with caution, and only in the absence of therapeutic alternatives, based on.the significant increase in cancer incidence in patients without a history of cancer, with tofacitinib compared to anti-TNF in a randomized clinical trial, and a modest but significant increase.with abatacept compared to other bDMARDs in some observational studies.Conclusion The 2023 EULAR Points to Consider provide guidance on the management of targeted therapies.in patients with IA and a history of cancer. The research agenda highlights the need for studies.to evaluate targeted therapies other than TNF inhibitors and anti-CD20 to address the evidence gaps in this setting.REFERENCES: NIL.Acknowledgements: NIL.Disclosure of Interests Eden Sebbag: None declared, Kim Lauper: None declared, Juan Molina Collada: None declared, Daniel Aletaha: None declared, Johan Askling: None declared, Karolina Benesova: None declared, Heidi Bertheussen: None declared, Samuel Bitoun: None declared, Ertugrul Cagri Bolek: None declared, Gerd Rüdiger Burmester: None declared, Helena Canhão: None declared, Katerina Chatzidionysiou: None declared, Jeffrey Curtis: None declared, François-Xavier Danlos: None declared, vera guimaraes: None declared, Merete Lund Hetland: None declared, Florenzo Iannone: None declared, Marie Kostine: None declared, Tue Wenzel Kragstrup: None declared, Tore K. Kvien Speakers bureau: Grünenthal, Sandoz, UCB, Consultant of: AbbVie, Amgen, Celltrion, Gilead, Novartis, Pfizer, Sandoz, UCB, Grant/research support from: AbbVie, Amgen, BMS, Galapagos, Novartis, Pfizer, UCB, Anne Regierer: None declared, Hendrik Schulze-Koops: None declared, Lucia Silva-Fernández Speakers bureau: Lilly, BMS, Abbvie, Novartis, Janssen., Consultant of: Novartis, MSD, Sanofi, Janssen, Pfizer, Zoltan Szekanecz: None declared, Maya H Buch: None declared, Axel Finckh Speakers bureau: AbbVie BMS, Pfizer Eli-Lilly Sandoz, Consultant of: AbbVie, Novartis, Pfizer, MSD, Lilly, Grant/research support from: AbbVie, BMS, Galapagos, Lilly, Pfizer, Jacques-Eric Gottenberg Consultant of: Abbvie, BMS, Galpagos, Gilead, Lily, Pfizer, Roche Chugai, Sanofi, UCB, Grant/research support from: Abbvie, BMS, Pfizer.

Originalsprog	Udefineret/Ukendt
Tidsskrift	Annals of the Rheumatic Diseases
Vol/bind	82
Nummer	Suppl 1
Sider (fra-til)	29-29
Antal sider	1
ISSN	0003-4967
DOI	https://doi.org/10.1136/annrheumdis-2023-eular.4789
Status	Udgivet - jun. 2023
Begivenhed	EULAR 2023 - Milan, Italien Varighed: 31 maj 2023 → …

Konference

Konference	EULAR 2023
Land/Område	Italien
By	Milan
Periode	31/05/2023 → …

Adgang til dokumentet

10.1136/annrheumdis-2023-eular.4789

https://ard.bmj.com/content/82/Suppl_1/29

Citationsformater

Sebbag, E., Lauper, K., Collada, J. M., Aletaha, D., Askling, J., Benesova, K., Bertheussen, H., Bitoun, S., Bolek, E. C., Burmester, G. R., Canhão, H. M., Chatzidionysiou, K., Curtis, J., Danlos, F. X., Guimaraes, V., Hetland, M. L., Iannone, F., Kostine, M., Kragstrup, T. W., ... Gottenberg, J. E. (2023). OP0045 EULAR POINTS TO CONSIDER ON THE INITIATION OF TARGETED THERAPIES IN PATIENTS WITH INFLAMMATORY ARTHRITIDES AND A HISTORY OF CANCER. Annals of the Rheumatic Diseases, 82(Suppl 1), 29-29. https://doi.org/10.1136/annrheumdis-2023-eular.4789

@article{255650ba2b0344d09ba663ab2b37e969,

title = "OP0045 EULAR POINTS TO CONSIDER ON THE INITIATION OF TARGETED THERAPIES IN PATIENTS WITH INFLAMMATORY ARTHRITIDES AND A HISTORY OF CANCER",

abstract = "Background Potential associations between targeted therapies and a new cancer in patients with an inflammatory arthritis (IA) and a history of malignant disease are a frequent concern in daily rheumatology practice. IA and/or immunomodulatory drugs might confer a specific risk of malignancy. No evidence-based framework has been proposed to guide clinicians on the benefit/risk balance when initiating or reinitiating a targeted therapy (bDMARDs/tsDMARDs) in this context.Objectives This initiative aimed to develop points to consider (PTC) to assist rheumatologists.when initiating/reinitiating a targeted therapy in the context of a previous malignancy.Methods Following EULAR standardised operating procedures, a task force of 2 patient representatives.and 25 experts (comprising 2 methodologists, 2 EMEUNET members, 1 oncologist.and 20 rheumatologists) first met to define the research questions for a systematic literature review concerning patients with IA and a history of cancer and other relevant information for consideration including: incidence of cancer in targeted therapy-treated patients and no history of cancer, translational research in onco-rheumatology, management with targeted therapy of immune-related adverse events of checkpoint inhibitors. In a second meeting, the task force formulated.the overarching principles and the PTC.Results The group formulated 5 overarching principles and 8 PTC relevant to the initiation of targeted therapies in patients with IA and a history of cancer. Major themes included a) the need to assess.the individualized risk of cancer recurrence based on the characteristics of the patient, the cancer and the underlying disease; b) the importance of engaging with specialists caring for the cancer and.to define treatment based on a shared decision between the patient and the rheumatologist;c) the possibility to initiate without delay an appropriate targeted therapy for the treatment of.the IA in patients in remission of their cancer; d) the proposal to prefer anti-cytokine bDMARDs.over other treatment options in patients with history of solid cancer and to prefer.B cell depleting therapy in patients with a history of lymphoma; e) the proposal to use JAK inhibitors and abatacept with caution, and only in the absence of therapeutic alternatives, based on.the significant increase in cancer incidence in patients without a history of cancer, with tofacitinib compared to anti-TNF in a randomized clinical trial, and a modest but significant increase.with abatacept compared to other bDMARDs in some observational studies.Conclusion The 2023 EULAR Points to Consider provide guidance on the management of targeted therapies.in patients with IA and a history of cancer. The research agenda highlights the need for studies.to evaluate targeted therapies other than TNF inhibitors and anti-CD20 to address the evidence gaps in this setting.REFERENCES: NIL.Acknowledgements: NIL.Disclosure of Interests Eden Sebbag: None declared, Kim Lauper: None declared, Juan Molina Collada: None declared, Daniel Aletaha: None declared, Johan Askling: None declared, Karolina Benesova: None declared, Heidi Bertheussen: None declared, Samuel Bitoun: None declared, Ertugrul Cagri Bolek: None declared, Gerd R{\"u}diger Burmester: None declared, Helena Canh{\~a}o: None declared, Katerina Chatzidionysiou: None declared, Jeffrey Curtis: None declared, Fran{\c c}ois-Xavier Danlos: None declared, vera guimaraes: None declared, Merete Lund Hetland: None declared, Florenzo Iannone: None declared, Marie Kostine: None declared, Tue Wenzel Kragstrup: None declared, Tore K. Kvien Speakers bureau: Gr{\"u}nenthal, Sandoz, UCB, Consultant of: AbbVie, Amgen, Celltrion, Gilead, Novartis, Pfizer, Sandoz, UCB, Grant/research support from: AbbVie, Amgen, BMS, Galapagos, Novartis, Pfizer, UCB, Anne Regierer: None declared, Hendrik Schulze-Koops: None declared, Lucia Silva-Fern{\'a}ndez Speakers bureau: Lilly, BMS, Abbvie, Novartis, Janssen., Consultant of: Novartis, MSD, Sanofi, Janssen, Pfizer, Zoltan Szekanecz: None declared, Maya H Buch: None declared, Axel Finckh Speakers bureau: AbbVie BMS, Pfizer Eli-Lilly Sandoz, Consultant of: AbbVie, Novartis, Pfizer, MSD, Lilly, Grant/research support from: AbbVie, BMS, Galapagos, Lilly, Pfizer, Jacques-Eric Gottenberg Consultant of: Abbvie, BMS, Galpagos, Gilead, Lily, Pfizer, Roche Chugai, Sanofi, UCB, Grant/research support from: Abbvie, BMS, Pfizer.",

author = "E. Sebbag and K. Lauper and Collada, {J. Molina} and D. Aletaha and Johan Askling and K. Benesova and H. Bertheussen and S. Bitoun and Bolek, {E. C.} and Burmester, {G. R.} and Canh{\~a}o, {Helena M.} and K. Chatzidionysiou and J. Curtis and Danlos, {F. X.} and V. Guimaraes and Hetland, {M. L.} and Florenzo Iannone and M. Kostine and Kragstrup, {T. W.} and Kvien, {T. K.} and A. Regierer and H. Schulze-Koops and L. Silva-Fern{\'a}ndez and Z. Szekanecz and Buch, {M. H.} and A. Finckh and Gottenberg, {J. E.}",

year = "2023",

month = jun,

doi = "10.1136/annrheumdis-2023-eular.4789",

language = "Udefineret/Ukendt",

volume = "82",

pages = "29--29",

journal = "Annals of the Rheumatic Diseases",

issn = "0003-4967",

publisher = "BMJ Publishing Group",

number = "Suppl 1",

note = "EULAR 2023 ; Conference date: 31-05-2023",

}

Sebbag, E, Lauper, K, Collada, JM, Aletaha, D, Askling, J, Benesova, K, Bertheussen, H, Bitoun, S, Bolek, EC, Burmester, GR, Canhão, HM, Chatzidionysiou, K, Curtis, J, Danlos, FX, Guimaraes, V, Hetland, ML, Iannone, F, Kostine, M, Kragstrup, TW, Kvien, TK, Regierer, A, Schulze-Koops, H, Silva-Fernández, L, Szekanecz, Z, Buch, MH, Finckh, A & Gottenberg, JE 2023, 'OP0045 EULAR POINTS TO CONSIDER ON THE INITIATION OF TARGETED THERAPIES IN PATIENTS WITH INFLAMMATORY ARTHRITIDES AND A HISTORY OF CANCER', Annals of the Rheumatic Diseases, bind 82, nr. Suppl 1, s. 29-29. https://doi.org/10.1136/annrheumdis-2023-eular.4789

OP0045 EULAR POINTS TO CONSIDER ON THE INITIATION OF TARGETED THERAPIES IN PATIENTS WITH INFLAMMATORY ARTHRITIDES AND A HISTORY OF CANCER. / Sebbag, E.; Lauper, K.; Collada, J. Molina et al.
I: Annals of the Rheumatic Diseases, Bind 82, Nr. Suppl 1, 06.2023, s. 29-29.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Konferenceabstrakt i tidsskrift › Forskning › peer review

TY - ABST

T1 - OP0045 EULAR POINTS TO CONSIDER ON THE INITIATION OF TARGETED THERAPIES IN PATIENTS WITH INFLAMMATORY ARTHRITIDES AND A HISTORY OF CANCER

AU - Sebbag, E.

AU - Lauper, K.

AU - Collada, J. Molina

AU - Aletaha, D.

AU - Askling, Johan

AU - Benesova, K.

AU - Bertheussen, H.

AU - Bitoun, S.

AU - Bolek, E. C.

AU - Burmester, G. R.

AU - Canhão, Helena M.

AU - Chatzidionysiou, K.

AU - Curtis, J.

AU - Danlos, F. X.

AU - Guimaraes, V.

AU - Hetland, M. L.

AU - Iannone, Florenzo

AU - Kostine, M.

AU - Kragstrup, T. W.

AU - Kvien, T. K.

AU - Regierer, A.

AU - Schulze-Koops, H.

AU - Silva-Fernández, L.

AU - Szekanecz, Z.

AU - Buch, M. H.

AU - Finckh, A.

AU - Gottenberg, J. E.

PY - 2023/6

Y1 - 2023/6

N2 - Background Potential associations between targeted therapies and a new cancer in patients with an inflammatory arthritis (IA) and a history of malignant disease are a frequent concern in daily rheumatology practice. IA and/or immunomodulatory drugs might confer a specific risk of malignancy. No evidence-based framework has been proposed to guide clinicians on the benefit/risk balance when initiating or reinitiating a targeted therapy (bDMARDs/tsDMARDs) in this context.Objectives This initiative aimed to develop points to consider (PTC) to assist rheumatologists.when initiating/reinitiating a targeted therapy in the context of a previous malignancy.Methods Following EULAR standardised operating procedures, a task force of 2 patient representatives.and 25 experts (comprising 2 methodologists, 2 EMEUNET members, 1 oncologist.and 20 rheumatologists) first met to define the research questions for a systematic literature review concerning patients with IA and a history of cancer and other relevant information for consideration including: incidence of cancer in targeted therapy-treated patients and no history of cancer, translational research in onco-rheumatology, management with targeted therapy of immune-related adverse events of checkpoint inhibitors. In a second meeting, the task force formulated.the overarching principles and the PTC.Results The group formulated 5 overarching principles and 8 PTC relevant to the initiation of targeted therapies in patients with IA and a history of cancer. Major themes included a) the need to assess.the individualized risk of cancer recurrence based on the characteristics of the patient, the cancer and the underlying disease; b) the importance of engaging with specialists caring for the cancer and.to define treatment based on a shared decision between the patient and the rheumatologist;c) the possibility to initiate without delay an appropriate targeted therapy for the treatment of.the IA in patients in remission of their cancer; d) the proposal to prefer anti-cytokine bDMARDs.over other treatment options in patients with history of solid cancer and to prefer.B cell depleting therapy in patients with a history of lymphoma; e) the proposal to use JAK inhibitors and abatacept with caution, and only in the absence of therapeutic alternatives, based on.the significant increase in cancer incidence in patients without a history of cancer, with tofacitinib compared to anti-TNF in a randomized clinical trial, and a modest but significant increase.with abatacept compared to other bDMARDs in some observational studies.Conclusion The 2023 EULAR Points to Consider provide guidance on the management of targeted therapies.in patients with IA and a history of cancer. The research agenda highlights the need for studies.to evaluate targeted therapies other than TNF inhibitors and anti-CD20 to address the evidence gaps in this setting.REFERENCES: NIL.Acknowledgements: NIL.Disclosure of Interests Eden Sebbag: None declared, Kim Lauper: None declared, Juan Molina Collada: None declared, Daniel Aletaha: None declared, Johan Askling: None declared, Karolina Benesova: None declared, Heidi Bertheussen: None declared, Samuel Bitoun: None declared, Ertugrul Cagri Bolek: None declared, Gerd Rüdiger Burmester: None declared, Helena Canhão: None declared, Katerina Chatzidionysiou: None declared, Jeffrey Curtis: None declared, François-Xavier Danlos: None declared, vera guimaraes: None declared, Merete Lund Hetland: None declared, Florenzo Iannone: None declared, Marie Kostine: None declared, Tue Wenzel Kragstrup: None declared, Tore K. Kvien Speakers bureau: Grünenthal, Sandoz, UCB, Consultant of: AbbVie, Amgen, Celltrion, Gilead, Novartis, Pfizer, Sandoz, UCB, Grant/research support from: AbbVie, Amgen, BMS, Galapagos, Novartis, Pfizer, UCB, Anne Regierer: None declared, Hendrik Schulze-Koops: None declared, Lucia Silva-Fernández Speakers bureau: Lilly, BMS, Abbvie, Novartis, Janssen., Consultant of: Novartis, MSD, Sanofi, Janssen, Pfizer, Zoltan Szekanecz: None declared, Maya H Buch: None declared, Axel Finckh Speakers bureau: AbbVie BMS, Pfizer Eli-Lilly Sandoz, Consultant of: AbbVie, Novartis, Pfizer, MSD, Lilly, Grant/research support from: AbbVie, BMS, Galapagos, Lilly, Pfizer, Jacques-Eric Gottenberg Consultant of: Abbvie, BMS, Galpagos, Gilead, Lily, Pfizer, Roche Chugai, Sanofi, UCB, Grant/research support from: Abbvie, BMS, Pfizer.

AB - Background Potential associations between targeted therapies and a new cancer in patients with an inflammatory arthritis (IA) and a history of malignant disease are a frequent concern in daily rheumatology practice. IA and/or immunomodulatory drugs might confer a specific risk of malignancy. No evidence-based framework has been proposed to guide clinicians on the benefit/risk balance when initiating or reinitiating a targeted therapy (bDMARDs/tsDMARDs) in this context.Objectives This initiative aimed to develop points to consider (PTC) to assist rheumatologists.when initiating/reinitiating a targeted therapy in the context of a previous malignancy.Methods Following EULAR standardised operating procedures, a task force of 2 patient representatives.and 25 experts (comprising 2 methodologists, 2 EMEUNET members, 1 oncologist.and 20 rheumatologists) first met to define the research questions for a systematic literature review concerning patients with IA and a history of cancer and other relevant information for consideration including: incidence of cancer in targeted therapy-treated patients and no history of cancer, translational research in onco-rheumatology, management with targeted therapy of immune-related adverse events of checkpoint inhibitors. In a second meeting, the task force formulated.the overarching principles and the PTC.Results The group formulated 5 overarching principles and 8 PTC relevant to the initiation of targeted therapies in patients with IA and a history of cancer. Major themes included a) the need to assess.the individualized risk of cancer recurrence based on the characteristics of the patient, the cancer and the underlying disease; b) the importance of engaging with specialists caring for the cancer and.to define treatment based on a shared decision between the patient and the rheumatologist;c) the possibility to initiate without delay an appropriate targeted therapy for the treatment of.the IA in patients in remission of their cancer; d) the proposal to prefer anti-cytokine bDMARDs.over other treatment options in patients with history of solid cancer and to prefer.B cell depleting therapy in patients with a history of lymphoma; e) the proposal to use JAK inhibitors and abatacept with caution, and only in the absence of therapeutic alternatives, based on.the significant increase in cancer incidence in patients without a history of cancer, with tofacitinib compared to anti-TNF in a randomized clinical trial, and a modest but significant increase.with abatacept compared to other bDMARDs in some observational studies.Conclusion The 2023 EULAR Points to Consider provide guidance on the management of targeted therapies.in patients with IA and a history of cancer. The research agenda highlights the need for studies.to evaluate targeted therapies other than TNF inhibitors and anti-CD20 to address the evidence gaps in this setting.REFERENCES: NIL.Acknowledgements: NIL.Disclosure of Interests Eden Sebbag: None declared, Kim Lauper: None declared, Juan Molina Collada: None declared, Daniel Aletaha: None declared, Johan Askling: None declared, Karolina Benesova: None declared, Heidi Bertheussen: None declared, Samuel Bitoun: None declared, Ertugrul Cagri Bolek: None declared, Gerd Rüdiger Burmester: None declared, Helena Canhão: None declared, Katerina Chatzidionysiou: None declared, Jeffrey Curtis: None declared, François-Xavier Danlos: None declared, vera guimaraes: None declared, Merete Lund Hetland: None declared, Florenzo Iannone: None declared, Marie Kostine: None declared, Tue Wenzel Kragstrup: None declared, Tore K. Kvien Speakers bureau: Grünenthal, Sandoz, UCB, Consultant of: AbbVie, Amgen, Celltrion, Gilead, Novartis, Pfizer, Sandoz, UCB, Grant/research support from: AbbVie, Amgen, BMS, Galapagos, Novartis, Pfizer, UCB, Anne Regierer: None declared, Hendrik Schulze-Koops: None declared, Lucia Silva-Fernández Speakers bureau: Lilly, BMS, Abbvie, Novartis, Janssen., Consultant of: Novartis, MSD, Sanofi, Janssen, Pfizer, Zoltan Szekanecz: None declared, Maya H Buch: None declared, Axel Finckh Speakers bureau: AbbVie BMS, Pfizer Eli-Lilly Sandoz, Consultant of: AbbVie, Novartis, Pfizer, MSD, Lilly, Grant/research support from: AbbVie, BMS, Galapagos, Lilly, Pfizer, Jacques-Eric Gottenberg Consultant of: Abbvie, BMS, Galpagos, Gilead, Lily, Pfizer, Roche Chugai, Sanofi, UCB, Grant/research support from: Abbvie, BMS, Pfizer.

U2 - 10.1136/annrheumdis-2023-eular.4789

DO - 10.1136/annrheumdis-2023-eular.4789

M3 - Konferenceabstrakt i tidsskrift

SN - 0003-4967

VL - 82

SP - 29

EP - 29

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

IS - Suppl 1

T2 - EULAR 2023

Y2 - 31 May 2023

ER -