Journal Article Review Ppublish
PubMed: 40382733 DOI: 10.1007/s40266-025-01214-4
Managing Rheumatoid Arthritis in Older Adults with Cancer.
Drugs Aging 42(7):599-614
Authors: Maria A Lopez-Olivo, Aliza R Karpes Matusevich, Jean H Tayar, Huifang Lu
Affiliations
- Department of Health Services Research, Unit 1303, The University of Texas MD Anderson Cancer Center, 1155 Pressler St, Houston, TX, 77030, USA.
- Biotechnology Research, ConcertAI, Cambridge, MA, USA.
- Section of Rheumatology and Clinical Immunology, Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Abstract
Rheumatoid arthritis (RA) is a chronic autoimmune condition disproportionately affecting older adults (> 60 years), who often experience increased disease severity and comorbidities, including cancer. A comprehensive review of the literature was conducted, examining the prevalence of malignancy in patients with RA, associated risk factors, and treatment challenges, including management considerations such as psychological distress and lifestyle modifications. Clinical guidelines and consensus statements were summarized to provide practical insights for optimizing care. Older adults with RA are at an elevated risk for developing cancer due to chronic inflammation, immunosenescence from aging, and shared risk factors such as smoking. Patients with RA tend to have poorer cancer survival rates than individuals without RA, particularly for lung cancer and lymphoma. Immunosuppressive therapies used to treat RA may modestly increase cancer risks but are critical for disease control. Current guidelines emphasize discontinuation or adjustment of RA therapies upon cancer diagnosis, with tailored approaches based on cancer type and stage. Non-pharmacologic interventions, including lifestyle modifications and psychological support, play a vital role in improving quality of life and mitigating disease flares during cancer treatment. The management of RA in older adults with a history of cancer requires a personalized, multidisciplinary approach that balances the need for RA symptom control without affecting cancer outcomes. Shared decision-making, incorporating patient preferences and comorbidities, is critical for optimizing care. Further research is needed to strengthen evidence-based guidelines for this population and address gaps in understanding treatment safety and efficacy.
MeSH
Comorbidity, Life Style, Neoplasms, Arthritis, Drug Therapy, Risk Factors, Arthritis, Rheumatoid, Therapeutics