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Rheumatoid Arthritis Drugs May Have Small Skin Cancer Risk

Study Shows TNF Inhibitors Have No Increased Risk of Other Cancers
WebMD Health News
Reviewed by Laura J. Martin, MD

Sept. 7, 2011 -- A popular class of rheumatoid arthritis drugs may slightly increase skin cancer risk but not the risk of other cancers, a "reassuring" study finds.

Cimzia, Enbrel, Humira, Remicade, and Simponi all inhibit a natural protein called tumor necrosis factor alpha (TNFa). TNFa plays a major role in arthritis. It also plays a major role in protecting the body from infections and cancer.

The clinical trials that led to the drugs' approval showed no sign of increased cancer risk. But cancer takes a long time to develop. Worries remained that as time went on, a cancer risk would appear, says University of Miami rheumatologist Ozlem Pala, MD.

A 2006 report in the Journal of the American Medical Association found evidence of increased cancers and serious infections in patients taking anti-TNF drugs. But later studies failed to confirm the cancer risk.

"We are more or less sure now we won't see a really big increased risk of cancer with these medicines," Pala tells WebMD. "It is definitely better than what we were afraid of. But we still have to be really cautious about the possibility of cancer risk [in patients on TNF inhibitors]."

A recent analysis of clinical trial data found no increased cancer risk for TNF inhibitors -- except for an increased risk of skin cancer. Now a new analysis of patient follow-up data confirms these findings, study leader Xavier Mariette, MD, PhD, of the University of Paris, tells WebMD.

"We had exactly the same results. It means there was no increased risk of cancer in patients treated with TNF inhibitors compared to [other RA drugs]," Mariette tells WebMD. "It is very reassuring. But we did also observe an increased risk of non-melanoma skin cancer."

Mariette and colleagues also found a trend indicating increased risk of melanoma in patients on TNF inhibitors -- but this finding was weak and could have been due to chance.

Mariette notes that anti-TNF drugs weaken part of the the immune system. And such drugs are known to increase the risk of skin cancers, he says, so he is not surprised to find that anti-TNF drugs increase non-melanoma skin cancer risk by 45%.

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