TNF Treatment for Rheumatoid Arthritis Boosts Skin Cancer
WEDNESDAY, Sept. 7 (HealthDay News) -- Treating rheumatoid
arthritis (RA) patients with tumor necrosis factor (TNF) inhibitors
appears to increase their risk of developing skin cancer, a new
review of prior research indicates.
However, TNF inhibitors, which include infliximab (Remicade),
adalimunab (Humira), and etanercept (Enbrel), do not appear to
boost the risk for developing other forms of cancer, the
The findings stem from an analysis of 21 previous studies
conducted between 1998 and 2010, as well as eight study summaries
that had been presented at research conferences during the same
timeframe. All the studies had focused on the potential for cancer
risk in association with the use of standard TNF inhibitors.
"This systematic review and meta analysis provides reassurance to physicians and patients that the treatment of [rheumatoid arthritis] with TNF inhibitors does not increase the risk of malignancy, particularly lymphoma," the French study team said in a news release from Annals of the Rheumatic Diseases, which published the report in its current online issue.
"However, it does appear to increase the risk of skin cancer, including melanoma," added the French team, led by Prof. Xavier Mariette from Paris-Sud University's rheumatology service in Ile de France.
The authors noted that RA has previously been shown to increase
the risk for developing certain types of cancer, including both
lung cancer and lymphoma, while decreasing the risk for other
cancers, including bowel and breast.
However, the question of TNF inhibitor treatments as a cancer
risk has remained a subject of debate.
The current review looked at a collection of studies involving a
total of more than 40,000 patients. The researchers estimate that,
spread across a population that large, this translates to about
150,000 cumulative years of exposure to TNF inhibitor drugs.
Seven of the studies indicated no notable risk increase for any
type of cancer associated with the use of TNF meds. Another two
long-term studies similarly suggested that while RA patients who
had previously had cancer faced a higher likelihood for a second
bout, TNF treatments alone posed no additional cancer risk.
But four other studies collectively demonstrated that TNF
inhibitors boosted the risk for non-melanoma skin cancer by 45
percent. And another two studies suggested that the RA treatment
raised the specific risk for developing melanoma by nearly 80
Dr. W. Hayes Wilson, chief of rheumatology at Piedmont Hospital
in Atlanta, said the findings should help guide physicians on
potential RA treatment complications.
"I don't think this is particularly surprising, given that there's long been a concern about cancer risk in the back of our minds," he noted. "And, in fac,t this is somewhat reassuring on the front of solid cancers that there's nothing to be alarmed about."
"But while we can perhaps now put aside our worries about other types of cancers, this does give us some indication that we need to be vigilant when it comes to skin cancer," Wilson added. "And we certainly need to have a high index of suspicion if a patient has a skin abnormality, and make certain that they see their dermatologist."
For more on rheumatoid arthritis, visit the
National Institutes of Arthritis and Musculoskeleta...nd Skin Diseases.
Copyright © 2011
. All rights reserved.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.