A new narrative review looked at the cancer risk of biologic and targeted synthetic drugs used for immune-mediated inflammatory arthritides, including rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis, and juvenile idiopathic arthritis. These drugs include TNF inhibitors, abatacept, rituximab, IL-6 inhibitors, IL-17/23 inhibitors, and JAK inhibitors.
The review found that most biologic therapies appear broadly reassuring when it comes to overall cancer risk. However, the most consistent signal was an increased risk of non-melanoma skin cancer, especially with TNF inhibitors and possibly abatacept. For JAK inhibitors, overall cancer rates were similar to TNF inhibitors, though lung and keratinocyte cancers occurred more often in certain high-risk groups.
It is important to note that this is a narrative review, not a systematic analysis, and it is based on data available up to early 2026. No meta-analysis was performed, so the findings are associations, not proven causes. The review did not provide absolute numbers or effect sizes.
What this means for patients: The risk of cancer with these medications appears low overall, but skin cancer risk may be higher with some drugs. Doctors should weigh the benefits of controlling inflammation against individual cancer risks. Patients should discuss their personal risk factors with their rheumatologist.