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From OncoLog, November-December 2012, Vol. 57, Nos. 11-12

In Brief

Biologic Therapies for Rheumatoid Arthritis Not Associated With Increased Cancer Risk

Biologic response modifiers (BRMs) for rheumatoid arthritis are not associated with an increased risk of cancer when compared with traditional rheumatoid arthritis treatments, according to the largest systematic review evaluating such risk in rheumatoid arthritis patients.

Among the BRMs used to treat rheumatoid arthritis are the tumor necrosis factor (TNF) inhibitors adalimumab, certolizumab pegol, etanercept, golimumab, and infliximab. BRMs are commonly prescribed as a second-line treatment if the standard disease-modifying antirheumatic drugs fail.

“These results are reassuring for patients considering biologic therapies for their rheumatoid arthritis.”
– Dr. Maria Suarez-Almazor
Because several cases of hepatosplenic T cell lymphoma have been reported in children and young adults treated with the drugs, the current U.S. Food and Drug Administration warning labels for all TNF inhibitors note the risk of malignancy. However, data from prior studies of malignancies in patients treated with TNF inhibitors were conflicting.

In the systematic review, researchers used the Cochrane Collaboration database to analyze the results from 29,423 patients in 63 randomized controlled trials of rheumatoid arthritis treatments. As a group, the trials selected compared the safety of BRMs against a placebo or traditional disease-modifying antirheumatic drugs (e.g., methotrexate, hydroxychloroquine, leflunomide) and included only patients who had a minimum of 6 months of follow-up.

The researchers observed no statistically significant increased risk of any type of cancer in patients treated with BRMs compared with the other medications or placebos. In the trials analyzed, 211 patients developed a malignancy. No significant differences existed between patients in the control groups who developed cancer and those treated with BRM therapies.

“Patients are understandably concerned when treatments are linked to cancer risk. These results are reassuring for patients considering biologic therapies for their rheumatoid arthritis,” said senior author Maria E. Suarez-Almazor, M.D., a professor in the Department of General Internal Medicine at The University of Texas MD Anderson Cancer Center. “With this knowledge, clinicians can effectively demonstrate that the benefits of BRMs far outweigh the risk.” The study’s report was published in the September 5 issue of the Journal of the American Medical Association.

For more information, talk to your physician, visit www.mdanderson.org, or call askMDAnderson at 877-632-6789.

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