How would you manage active axial spondyloarthritis in a patient with recent (<5 years) solid malignancy who completed chemotherapy?  

I wouldn't be too concerned about employing a TNF inhibitor, but the malignancy data for IL-17 inhibitors—and the lack of any black box malignancy warning—are more reassuring. I would probably choose the IL-17 inhibitor unless there is comorbid IBD.

While there is no direct evidence regarding how to manage patients with axSpA and recent solid malignancy, I have used the 2015 ACR RA treatment guidelines to extrapolate. These RA treatment guidelines say that for RA patients with previously treated malignancy, the recommendations are the same as i...

I think data for biologics and malignancy are inconclusive to be 100% sure. Based on limited evidence and clinical trial data, my choices would be IL 17 first then Anti TNF if needed. Would avoid JAK-i. 

I would try to utilize ACR guideline for RA management in patients with malignancy to answer this question. TNFi are not contraindicated in patients with solid malignancy and can be used in patients, if they have already failed the approved IL-17i. In biologic naive patients, I would prefer to start...

Sharing this recently published study (February 2025) done at MD Anderson Cancer Center on around 1,981 patients with solid early-stage (localized or regional) cancer (prostate, colorectal, and lung cancer)—it showed that TNFi use in the first 3 years did not affect survival.Ruiz et al., PMID ...