Research: Anti-tumor necrosis factor treatment does not increase cancer Risk in RA patients

http://www.eurekalert.org/pub_releases/2009-10/w-anf102809.php

Anti-tumor necrosis factor treatment does not increase cancer Risk in
RA patients
Overall cancer risk comparable to those not taking immunosuppressive
drugs

A recent study by Swedish researchers found that rheumatoid arthritis
(RA) patients did not experience an elevated cancer risk in the first
6 years after starting anti-tumor necrosis factor (TNF) therapy. The
research team, led by Johan Askling, M.D., Ph.D., from Karolinska
University Hospital in Stockholm, Sweden assessed the short-term and
medium-term cancer risk for RA patients using anti-TNF therapies:
infliximab, adalimumab, and etanercept. Details of the study appear in
the November issue of Arthritis & Rheumatism, a journal of the
American College of Rheumatology published by Wiley-Blackwell.

TNF is a cytokine (substance secreted by immune system cells) that
regulates the body's immune system and is involved in inflammation.
TNF inhibitors (or TNF blockers) are a class of therapies used to
reduce inflammation in chronic inflammation such as RA. The common
immunosuppressant drugs and those included in the study are Remicade®,
HumiraTM, and Enbrel®. As these therapies are used to treat chronic
inflammatory illnesses, the long-term inhibition of TNF raises
concerns for increased risk of infections and cancer.

This study, one of the largest and longest population-based
assessments of cancer risks associated with immunosuppressive therapy,
included data from several Swedish databases including the Biologics
Register, the Cancer Register, and the Early RA Register. Researchers
identified and analyzed data from 6,366 patients who started anti-TNF
therapy between January 1999 and July 2006. Data from patients using
TNF inhibitors was compared with other groups of RA patients—61,160
not taking medication, 4015 using methotrexate (the gold standard in
RA treatment) and 4,015 taking combinations of disease-modifying anti-
rheumatic drugs (other than TNF inhibitors).

Results show there were 240 first primary cancers diagnosed during the
25,693 person-years of follow-up in the patients using anti-TNF
therapy who had no history of cancer at the onset of immunosuppressant
treatment. When compared to the larger national RA cohort who did not
receive TNF inhibitors or have a history of cancer, the relative risk
of anti-TNF therapy was 1.00 and remained unchanged for those taking
immunosuppressant drugs for up to 6 years. "Our research indicates the
overall cancer risk is the same for RA patients on immunosuppressant
therapies and those not taking medications for the disease," confirmed
Dr. Askling, but adds that "given several remaining uncertainties,
continued vigilance remains prudent."

--
Luke
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