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?

Answer from: at Academic Institution

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.

Comments

at Tidalhealth
Agree with @Laura. Conversation with patient shari...

at Advanced Dermatology and Cosmetic Surgery
Agree… or something simpler like MTX.

Answer from: at Community Practice

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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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?

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