How would you approach management of a patient who develops squamous cell skin cancer while on abatacept?

I would discontinue abatacept. Several studies now have reported an increased risk of squamous cell cancer/non-melanoma skin cancers in patients on abatacept (Wadstrom et al., PMID 28975211, Simon et al., PMID 37932010) and in someone who actually develops this malignancy on the drug, I would hesita...

If the patient was well controlled on Abatacept, I would discuss with the patient either continuing this medication with close follow up with Dermatology, vs change to a different medication with the risk of poorer efficacy and other potential side effects.

In general, Abatacept has a lower risk of ...