According to an article recently published in the Journal of the American Medical Association, patients taking the rheumatoid arthritis drugs Remicade® (infliximab) or Humira® (adalimumab) had a three-fold increased risk of developing various types of cancers.
Remicade and Humira are agents referred to as anti-tumor necrosis factor (Anti-TNF) antibodies; they have demonstrated effectiveness in the treatment of severe rheumatoid arthritis. An issue surrounding these agents is that tumor necrosis factor is thought to provide protection against cancer and infection. The use of anti-TNFs that block the productivity of tumor necrosis factor has thus been associated with an increased risk of infection and possibly various types of cancers.
Researchers from the Mayo Clinical conducted a study to further evaluate the potential effects of Remicade and Humira on the incidence of cancer. The study included data from nine clinical trials that compared anti-TNF therapy to placebo (inactive substitute) in patients with rheumatoid arthritis. The studies included over 3,000 persons receiving anti-TNF therapy and over 1,500 receiving placebo (control group).
- Patients taking anti-TNF therapy had over a three-fold increased risk in developing a cancer than the control group.
- Patients treated with high doses of anti-TNF therapy had a 4.3-fold increased risk of developing cancer compared to the control group.
- Patients treated with low doses of anti-TNF therapy had a 1.4-fold increased risk of developing cancer compared to the control group.
- Types of cancers that were increased were lymphomas, skin cancer, breast cancer, lung cancer, and gastrointestinal tract cancers.
- This data represents one additional cancer for every 154 patients treated with anti-TNF therapy.
The researchers concluded that treatment with anti-TNF therapy increases the risk of developing cancers, particularly among patients treated with high doses of this type of therapy. Patients undergoing treatment with anti-TNF therapy should speak with their physician regarding their individual risks and benefits of treatment.
Reference: Bongartz T, Sutton AJ, Sweeting MJ, et al. Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serous infections and malignancies. Journal of the American Medical Association. 2006;295:2275-2285.
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