Arthritis Drugs May Up Cancer Risk
Study Also Shows TNF-Blockers May Increase Risk of Infection
Higher Doses, More Cancers continued...
The analysis included nine trials of Remicade and Humira involving 3,493 patients treated with the TNF-blocking antibodies and 1,512 patients treated with placebo instead of the biologics. The shortest trial in the analysis was 12 weeks long and the longest was 54 weeks.
All data on serious infections (such as pneumoniapneumonia) and cancers were pooled; the cancer risk among patients taking the biologics was found to be 3.3 times that of placebo-treated patients.
Twenty-nine malignancies were reported among the roughly 3,500 patients who got the active biologic, compared to three malignancies among the roughly 1,500 placebo-treated patients.
The most cancers were seen among patients treated with the highest doses of the TNF-inhibiting drugs; lymphomas and basal cell cancers were the most commonly reported malignancies.
Few Other Options
Matteson says he continues to use the biologics in many of his patients, but he adds that it is important to make patients aware of the potential risks when considering treatment options.
"Most of the patients appropriate for this therapy do not have other good options," he says. TNF-blocking agents "have revolutionized the way we treat rheumatoid arthritisarthritis, especially in patients who do not respond to conventional therapies."
Mount Sinai School of Medicine rheumatologist Robert Lahita, MD, PhD, agrees. He says the newly published analysis is important because it is the first study to quantify the cancer risk associated with the use of these drugs.
He points out that the cancers seen most often in the study tend to be highly treatable. And he adds that patients with few other arthritis treatment alternatives will probably consider the risk acceptable.
"The change in patients who are virtually crippled by this disease when you give them a TNF-inhibitor can be miraculous," he says. "For these patients, the benefits of taking these drugs will continue to outweigh the risks."
Remicade is also used to treat other conditions including Crohn's disease, ankylosing spondylitis, ulcerative colitisulcerative colitis, and psoriatic arthritis.