Survival in patients with rheumatoid arthritis and concomitant melanoma receiving disease-modifying antirheumatic therapy
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Presented at: Society for Investigative Dermatology 2025
Date: 2025-05-07 00:00:00
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Summary: This retrospective cohort study investigates the survival of patients with rheumatoid arthritis (RA) diagnosed with melanoma, and receiving disease-modifying antirheumatic drugs (DMARDs) after diagnosis. Utilizing SEER-Medicare Melanoma, we analyzed overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) in RA patients aged ≥66 diagnosed with <i>in situ</i>, localized, or regional melanoma between 2008 and 2017. Patients were categorized by DMARD exposure within one-year post-melanoma diagnosis: no DMARDs (n=183), methotrexate (MTX) alone (n=137), or tumor necrosis factor-alpha inhibitors (TNFi) alone or with MTX (n=99). A 1-year landmark analysis was conducted on 419 patients with RA and melanoma with a mean age of 76 years and a median follow-up of 5 years. After multivariable adjustment including stage and propensity score, there was no statistical difference between TNFi (HR 0.65, 95% CI 0.34-1.25), or MTX (HR 0.94, 95% CI 0.58-1.52) compared to the no DMARDs group in OS, or between TNFi (HR 0.51, 95% CI 0.21-1.22) or MTX (HR 0.98, 95% CI 0.51-1.87) compared to the no DMARDs group in RFS. DSS was 95% (95% CI 91%-97%) overall, with no significant differences between groups. Older age, comorbidities, frailty, and steroid use were associated with decreased OS. Our results suggest that TNFi and MTX do not negatively impact survival in patients with RA and melanoma, but further research is needed to explore other biologic therapies and outcomes in younger patients. Isaac Weber<sup>1</sup>, Xiudong Lei<sup>1</sup>, Juan Ruiz<sup>3</sup>, Hui Zhao<sup>1</sup>, Sharon Giordano<sup>1</sup>, Jennifer McQuade<sup>2</sup>, Mackenzie Wehner<sup>1</sup>, Maria Suarez-Almazor<sup>1</sup> 1. Health Services Research, The University of Texas MD Anderson Cancer Center Division of Cancer Prevention and Population Sciences, Houston, TX, United States. 2. Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center Division of Cancer Medicine, Houston, TX, United States. 3. Clinical Medicine, Hospital Aleman, Buenos Aires, Buenos Aires, Argentina. Clinical Research: Epidemiology and Observational Research