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Topics:
Rheumatology • Rheumatoid Arthritis • Biologics • Dermatology • Cutaneous Squamous Cell Carcinoma
How would you approach management of a patient who develops squamous cell skin cancer while on abatacept?
Patient has had previous failure of methotrexate. Would you switch to alternative (TNFi or Rituximab) or continue abatacept with regular dermatology follow up?
Answer from: at Academic Institution
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...
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Answer from: at Community Practice
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...