Navigation Links
Biologic treatment for rheumatoid arthritis and the risk of cancer
Date:8/28/2007

The relationship between rheumatoid arthritis (RA), an autoimmune disease marked by chronic inflammation of the joints and tissue surrounding vital organs, and the incidence of cancer is complicated. Epidemiologic studies have generally demonstrated that blood, lung, and skin cancers are increased among RA patients, while breast and colon cancers are decreased. Whether these cancer rates are caused by the nature of RA or by immunosuppressive drugs used to treat RA is an issue of ongoing debate and investigation. Findings of various clinical trials and observational studies conflict over the risk of malignancy related to the use of tumor necrosis factor alpha (TNF ) blockers, a biologic therapy shown effective at controlling the symptoms of RA in patients who fail to respond to traditional disease-modifying antirheumatic drugs (DMARDs).

To assess the risk of cancer among biologic-treated RA patients, comprehensively and conclusively, two research specialists, Frederick Wolfe, MD, University of Kansas School of Medicine, and Kaleb Michaud, PhD, University of Nebraska Medical Center, turned to two sweeping databases, the National Data Bank for Rheumatic Diseases and the US National Cancer Institute SEER (Surveillance, Epidemiology, and End-Results). Gathering and comparing data from both, they studied the incidence of cancer in 13,001 RA patients, over a total span of close to 49,000 years. Nearly half of these patients, 49 percent, had a history of exposure to anti-TNF drugs. As Dr. Wolfe and Dr. Kaleb found, and report in the September 2007 issue of Arthritis & Rheumatism (http://www.interscience.wiley.com/journal/arthritis), biologic treatment of RA increases a patients risk of skin cancers, including melanoma, but not any other specific cancers?not lung, liver, brain, or bone cancers, not Hodgkins or leukemia, not solid tumors or lymphomaand not of developing cancer in general.

Among the study population, Dr. Wolfe and Dr. Kaleb identified 623 cases of skin cancer and 537 cases of other cancers. Then, they set out to determine the impact of biologic drug use on cancer occurrence. As an estimate of the relative risk of developing different types of cancer, the team calculated the odds ratio for every cancer afflicting the subjects, performing conditional logistic regression to reduce the effect of variations in treatment duration. They also controlled for the variables of sex, smoking history, education level, disease severity, and baseline use of prednisone. In addition to assessing the risk of various cancers associated with biologic treatment in general, Dr. Wolfe and Dr. Kaleb extended the analyses to individual TNF blockers, etanercept and infliximab.

Collectively and individually, anti-TNF therapy was linked to an increased risk of skin cancers. The odds ratio for developing melanoma was 2.3. Biologic use had no impact on any other type of cancer. The overall risk for all malignancies was 1.0a result substantially different from the overall risk of 3.3 noted in a meta-analysis of clinical trials of biologic treatment of RA.

Although our data do not show associations between malignancy and biologic therapy, except for skin cancers, the mean and median exposure to biologics was only 3.0 years, notes Dr. Michaud. It is possible that with increasing time of followup or of exposure, the association between malignancy and biologic therapy would become stronger. However, true associations are regularly seen within this time frame.

Despite its potential limitations, this study offers reassurance to RA patients who are currently being treated with etanercept or infliximab, as well as to those considering biologic therapy as a possible option.


'/>"/>
Contact: Amy Molnar
amolnar@wiley.com
John Wiley & Sons, Inc.
Source:Eurekalert

Related medicine news :

1. Smallpox as Biological Weapons?
2. Hyperactivity disorder a biological malfunction
3. Biologicals Transfer Proposal between US and Indian Biotechnology
4. Novel Biological Pacemaker Under Construction for Weak Hearts
5. Biologically Women Are More Vulnerable To HIV Infection
6. Biological Clock Could Be Re-Set: Study
7. Gold Nanoparticles Are Good Detectors Biological Toxins
8. Sunglasses Can Really Pull a Fast One on the Biological Clock, and Set a Lag in the Build Up Of Jet Lag
9. Can Men Gauge Biological Paternity Accurately
10. B-Cell Biologic Therapy Could Revolutionize Rheumatoid Arthritis Treatment
11. Best out of waste: Microbiological revolution!
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... (PRWEB) , ... October 13, 2017 , ... The American ... to become its next President and Chief Executive Officer, succeeding Dr. James C. Puffer ... Elect beginning July 1, 2018 until Dr. Puffer’s retirement at the end of 2018. ...
(Date:10/13/2017)... ... October 13, 2017 , ... Lori R. Somekh, founder of ... ElderCounsel, a national organization of elder law and special needs planning attorneys. “Membership in ... It also provides a forum to network with elder law attorneys nationwide,” said Somekh. ...
(Date:10/13/2017)... York, NY (PRWEB) , ... October 13, 2017 , ... ... influential people in business to advocate for action towards gender equality at their inaugural ... views from around the globe, and reached a social audience of over 3 million. ...
(Date:10/13/2017)... ... October 13, 2017 , ... Coveros, a leader ... been awarded a contract by the Center for Medicare and Medicaid Services (CMS). ... the enterprise use of Agile methodologies in a consistent and high value manner ...
(Date:10/12/2017)... CA (PRWEB) , ... October 12, 2017 , ... ... Cheng, are now treating sleep apnea using cutting-edge Oventus O2Vent technology. ... a serious sleep disorder characterized by frequent cessation in breathing. Oral appliances can ...
Breaking Medicine News(10 mins):
(Date:9/19/2017)... , Sept. 19, 2017   ZirMed Inc ., ... analytics, today announced that it has been ranked #1 by ... Black Book™ Rankings 2017 User Survey. ZirMed was recognized ... for large hospitals and medical centers over 200 beds and ... Book,s healthcare technology user survey history. ...
(Date:9/18/2017)... 2017 EpiVax, Inc. ("EpiVax") a ... immune engineering, today announced a new NIH-funded ... ... and presents a challenge for traditional flu ... be effective. Using state-of-the-art bioinformatics and molecular modeling methods, ...
(Date:9/12/2017)... NEW YORK , Sept. 12, 2017   EcoVadis , ... supply chains, has published the first annual edition of its Global CSR ... than 20,400 companies evaluated by EcoVadis, based on Scorecard Ratings that analyzed ... ... & Performance Index ...
Breaking Medicine Technology: