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Rheumatology • Rheumatoid Arthritis
How would you approach managing a patient with well-controlled RA on abatacept who develops a solid malignancy?
Is there evidence that abatacept can make it grow and spread more quickly compared to alternative therapies such as TNFs?
Answer from: at Academic Institution
Ok- good question:I would switch to an IL6inhibiton and let oncology do their thing.Make sure they are on Plaquenil too. :)Also, if the patient is going to get traditional chemo - watch and wait, likely the RA will be controlled with blanket immunosuppression of chemotherapy.Petit et al., PMID 39241...
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Answer from: at Community Practice
Great point: sit back and do nothing, sometimes freq steroids and chemo or transplant meds can control the RA for you.
I agree I have had to discontinue both orencia (which MOA is the antidote to immune checkpoint inhibitors) and Janus Kinase in favor of IL-6 Actemra or, depending on the type of ca...