What biologics would you use in a patient with rheumatoid arthritis who developed multiple basal cell carcinomas requiring Mohs surgery while on a TNF-inhibitor and did not respond to rituximab?
Would you switch to a biologic with a different mechanism of action and if so, what options would you consider?
2 Answers
Mednet MemberInvited Expert
Rheumatology · Johns Hopkins School of Medicine
Answered on
It would be a discussion with the patient about risks and benefits if the RA is well controlled on a TNF-inhibitor. If the patient wanted to switch, I'd consider switching to an IL-6R inhibitor like tocilizumab or sarilumab.
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Mednet Member
Dermatology · Dept Dermatology Jefferson Medical College
Answered on
Why is it an issue? TNF inhibitors do not promote BCCs.
If you have data that they do, cite the study, please.
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