Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Biologic treatment for rheumatoid arthritis and the risk of cancer

30.08.2007
Study of large US database associates anti-TNFá therapy with increased risk for skin cancers, but not tumors or lymphoma

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 (TNFá) 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-TNFá 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 patient’s risk of skin cancers, including melanoma, but not any other specific cancers—not lung, liver, brain, or bone cancers, not Hodgkin’s or leukemia, not solid tumors or lymphoma—and 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 TNFá blockers, etanercept and infliximab.

Collectively and individually, anti-TNFá 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 1.0—a 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.

Amy Molnar | EurekAlert!
Further information:
http://www.wiley.com

More articles from Health and Medicine:

nachricht New malaria analysis method reveals disease severity in minutes
14.08.2017 | University of British Columbia

nachricht New type of blood cells work as indicators of autoimmunity
14.08.2017 | Instituto de Medicina Molecular

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Exotic quantum states made from light: Physicists create optical “wells” for a super-photon

Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.

Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...

Im Focus: Circular RNA linked to brain function

For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.

While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...

Im Focus: RAVAN CubeSat measures Earth's outgoing energy

An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.

The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...

Im Focus: Scientists shine new light on the “other high temperature superconductor”

A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.

Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...

Im Focus: Scientists improve forecast of increasing hazard on Ecuadorian volcano

Researchers from the University of Miami (UM) Rosenstiel School of Marine and Atmospheric Science, the Italian Space Agency (ASI), and the Instituto Geofisico--Escuela Politecnica Nacional (IGEPN) of Ecuador, showed an increasing volcanic danger on Cotopaxi in Ecuador using a powerful technique known as Interferometric Synthetic Aperture Radar (InSAR).

The Andes region in which Cotopaxi volcano is located is known to contain some of the world's most serious volcanic hazard. A mid- to large-size eruption has...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Call for Papers – ICNFT 2018, 5th International Conference on New Forming Technology

16.08.2017 | Event News

Sustainability is the business model of tomorrow

04.08.2017 | Event News

Clash of Realities 2017: Registration now open. International Conference at TH Köln

26.07.2017 | Event News

 
Latest News

New thruster design increases efficiency for future spaceflight

16.08.2017 | Physics and Astronomy

Transporting spin: A graphene and boron nitride heterostructure creates large spin signals

16.08.2017 | Materials Sciences

A new method for the 3-D printing of living tissues

16.08.2017 | Interdisciplinary Research

VideoLinks
B2B-VideoLinks
More VideoLinks >>>