Manchester, UK—Although biologic therapies are widely prescribed immunomodulatory agents, concerns remain that long-term treatment could increase melanoma risks for inflammatory bowel disease (IBD), rheumatoid arthritis (RA), and psoriasis patients.

A study published in JAMA Dermatology examined whether biologic treatment of IBD, RA, or psoriasis is associated with an increased risk of melanoma compared with conventional systemic therapy. To do that, University of Manchester–led researchers searched Embase, MEDLINE, and the Cochrane Central Register of Controlled Trials (CENTRAL) for articles published from January. 1, 1995, to February 7, 2019, for eligible studies.

Randomized clinical trials, cohort studies, and nested case-control studies quantifying the risk of melanoma in patients treated with biologics for IBD, RA, and psoriasis compared with patients treated with conventional systemic therapy were included. In addition, two reviewers independently extracted key study characteristics and outcomes.

The meta-analysis sought to determine the pooled relative risk (pRR) of melanoma in biologic-treated patients with IBD, RA, and psoriasis compared with biologic-naive patients treated with conventional systemic therapy. To do that, researchers used seven cohort studies involving 34,029 patients treated with biologics and 135,370 biologic-naive patients treated with conventional systemic therapy.

Results indicate that biologic treatment was positively associated with melanoma in patients with IBD (pooled relative risk [pRR], 1.20; 95% CI, 0.60-2.40), RA (pRR, 1.20; 95% CI, 0.83-1.74), or psoriasis (hazard ratio, 1.57; 95% CI, 0.61-4.09) compared with those who received conventional systemic therapy, but the differences were not statistically significant.

“The findings suggest that clinically important increases in melanoma risk in patients treated with biologic therapy for common inflammatory diseases cannot be ruled out based on current evidence,” the authors conclude. “However, further studies with large patient numbers that adjust for key risk factors are needed to resolve the issue of long-term safety of biologic therapy.”

“The results of our study correspond with those of the previous analysis, suggesting that treatment with biologics is not significantly associated with an increased risk of melanoma in patients with RA compared with biologic-naive patients treated with conventional systemic therapy,” according to researchers.

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