How do you approach treatment of a patient with active RA and a history of Lynch Syndrome?

The presence of hereditary polyposis coli and its predisposition to colon cancer should have little effect on the management of RA.

Available data indicate that methotrexate has at best a neutral effect on predisposition to malignancy. There are data to suggest that the combination of methotrexate and a TNFi may reduce the incidence of cancer. With respect to the biologic therapies, the only increase, which is at best is slight, is an increase in non-Hodgkin lymphoma. Based on the available data...