Initiating targeted therapy according to EULAR recommendations in patients with inflammatory joint diseases and a history of malignancy

The potential link between targeted therapies and malignancies (MN) in patients with inflammatory joint diseases and a history of MNs remains a frequent concern in routine rheumatological practice.In 2024, the EULAR (European Alliance of Associations for Rheumatology) task force formulated five overarching principles and seven hypotheses regarding the initiation of targeted therapy in patients with active arthritis and MN in remission, as well as one hypothesis for patients with active arthritis who have not achieved remission of the oncological disease.Key considerations included: a) the necessity of assessing the individual risk of cancer recurrence based on patient-specific factors, the type of MN, and the underlying disease; b) the importance of close cooperation with oncology specialists and determining the therapeutic strategy through shared decision-making between the patient and rheumatologist; c) the need for the timely initiation of appropriate targeted arthritis therapy in patients with cancer remission; d) a recommendation to use Janus kinase inhibitors and abatacept cautiously and only when no alternatives are available, due to the lack of data on their use in patients with prior MN.These guidelines identify specific points that require particular attention when prescribing targeted therapy to patients with active arthritis and a history of MN.