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Aktuelle Rheumatologie 2020; 45(06): 523-530
DOI: 10.1055/a-1247-4252
Übersichtsarbeit

Rheumatologische medikamentöse Therapie bei Malignomanamnese

Rheumatological Drug Treatment in Patients with a History of Malignancy
Marc Schmalzing
1   Rheumatologie / Klinische Immunologie, Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Würzburg
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Zusammenfassung

Rheumatologische Therapie bei Patienten mit Malignomanamnese ist mit komplexen Fragestellungen verbunden. Schwierigkeiten und Lösungsmöglichkeiten bei der Interpretation aussagekräftiger Studien werden dargestellt. Empfehlungen in Leitlinien zu diesem Thema werden diskutiert. Nationale Register und Versicherungsdatenbanken wurden mit der Frage nach Tumorrezidivrisiko unter Basistherapeutika untersucht ; diese Analysen beziehen sich aber v. a. auf TNF-Inhibitoren und Rituximab. Zu den gängigen Substanzen der Basistherapie werden Daten zur Tumorinzidenz und wenn vorhanden zum Tumorrezidivrisiko zusammengefasst. Abschließend wird der Versuch unternommen Vorschläge zur rheumatolgischen Therapie bei Malignomanamnese zu formulieren.

Abstract

Rheumatological therapy in patients with a history of malignancy is associated with complex questions. Difficulties and possible solutions in the interpretation of meaningful studies are presented. Recommendations in guidelines on this topic are discussed. National registries and insurance databases have been examined as to the tumour recurrence risk under disease-modifying antirheumatic drugs; however, these analyses mainly refer to TNF inhibitors and rituximab. Data on tumor incidence and, if available, tumor recurrence risk are summarized for common disease-modifying antirheumatic drugs. Finally, an attempt is made to formulate proposals for rheumatological therapy in patients with a history of malignancy.

Schlüsselwörter

Basistherapie - Malignom - Immunsuppression

Key words

DMARD - malignancy - immunosuppression


Publication History

Article published online:
21 October 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
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