 |
|
Rheumatoid arthritis drug linked to serious infections and cancers
May 17, 2006ROCHESTER, Minn. - A new meta-analysis of many previous studies of TNF- (tumor necrosis factor) blocking antibodies for treatment of rheumatoid arthritis has confirmed a previously discovered increased risk for serious infection and has found that cancer also is a potential risk associated with the drugs.
"This study shows a strong association between treatment with TNF-blocking antibodies and the development of serious infections, such as pneumonia, and cancers," says Eric Matteson, M.D., Mayo Clinic rheumatologist and a senior study investigator. "It's a very serious issue. TNF-blocking antibodies are effective for treatment for rheumatoid arthritis and related conditions, but patients and health care providers must know that there is an increased risk for these complications and be alert for them."
More than half a million patients have received therapy with TNF-blocking antibodies. Patients treated with these drugs usually have not had favorable results with other drug treatments for rheumatoid arthritis or have more severe disease, according to Dr. Matteson. The drugs also are used to treat psoriasis, Crohn's disease and other conditions.
The study involved a systematic literature search for trials of TNF-blocking antibodies for rheumatoid arthritis. In addition, the researchers searched for such trials in the abstract databases of the scientific meetings of the American College of Rheumatology and the European League Against Rheumatism through December 2005 and conducted interviews with the manufacturers of the two licensed TNF-blocking antibodies, infliximab and adalimumab. The investigators found nine trials that met their inclusion criteria, including 3,493 patients who received TNF-blocking antibodies and 1,512 patients who received placebo. They gathered all data related to serious infections and malignancies in the studies' participants. Collectively, using various types of analyses, the researchers found that those treated with TNF-blocking antibodies had 3.3 times the risk of developing cancer than those given placebo, and 2.2 times the risk of serious infection. Cancers were much more common in those patients treated with high doses of TNF-blocking antibodies.
Dr. Matteson explains that TNF-blocking antibodies might be connected with an increased risk for infection and malignancies because the drugs interfere with immunological mechanisms critical to fighting infection and the body's normal function in surveying itself for cancerous cells.
The risk patients undertake when receiving TNF-blocking antibody treatment is "moderate," according to Dr. Matteson. He explains that, on average, rheumatoid arthritis patients are already at twice the risk of serious infections as others, and that taking TNF-blocking antibodies increases that risk.
The decision whether to have TNF-blocking antibody therapy for rheumatoid arthritis must be made by each patient and physician, according to Dr. Matteson. He continues to use this therapy for some patients, he says.
"Most of the patients appropriate for this therapy do not have other good options," he says. "TNF-blocking antibodies are absolutely the best drug for many patients. They have revolutionized the way we treat rheumatoid arthritis, especially in patients who do not respond to conventional therapies. So, I'm not looking to get rid of this therapy. I want to see it used safely."
Dr. Matteson strongly encourages patients who are prescribed TNF-blocking antibodies for rheumatoid arthritis to be especially alert to symptoms of infection, to get their vaccinations, and to undergo cancer screening appropriate for their age and gender.
Tim Bongartz, M.D., Mayo Clinic rheumatology research fellow who led the study, cautions that this study was not a final, overall risk-benefit analysis for TNF-blocking antibodies.
"Even though we detected an increase in malignancies and serious infections, it does not mean that overall the risks outweigh the benefits for patients," he says. "The short duration of trials included in our analysis does not allow any conclusions about the long-term risks of TNF-blocking antibody treatment in rheumatoid arthritis. It may turn out that the sustained beneficial effect of these drugs on patient mobility and general health will have a significant positive impact on the overall survival of patients."
The researchers hope the unique analysis method used in this study can be used in the future to look for rare, negative events during the course of studies of new drugs, so that the public can be alerted to any risks when the drug comes on the market.
Mayo Clinic
The study involved a systematic literature search for trials of TNF-blocking antibodies for rheumatoid arthritis. In addition, the researchers searched for such trials in the abstract databases of the scientific meetings of the American College of Rheumatology and the European League Against Rheumatism through December 2005 and conducted interviews with the manufacturers of the two licensed TNF-blocking antibodies, infliximab and adalimumab. The investigators found nine trials that met their inclusion criteria, including 3,493 patients who received TNF-blocking antibodies and 1,512 patients who received placebo. They gathered all data related to serious infections and malignancies in the studies' participants. Collectively, using various types of analyses, the researchers found that those treated with TNF-blocking antibodies had 3.3 times the risk of developing cancer than those given placebo, and 2.2 times the risk of serious infection. Cancers were much more common in those patients treated with high doses of TNF-blocking antibodies.
Dr. Matteson explains that TNF-blocking antibodies might be connected with an increased risk for infection and malignancies because the drugs interfere with immunological mechanisms critical to fighting infection and the body's normal function in surveying itself for cancerous cells.
The risk patients undertake when receiving TNF-blocking antibody treatment is "moderate," according to Dr. Matteson. He explains that, on average, rheumatoid arthritis patients are already at twice the risk of serious infections as others, and that taking TNF-blocking antibodies increases that risk.
The decision whether to have TNF-blocking antibody therapy for rheumatoid arthritis must be made by each patient and physician, according to Dr. Matteson. He continues to use this therapy for some patients, he says.
"Most of the patients appropriate for this therapy do not have other good options," he says. "TNF-blocking antibodies are absolutely the best drug for many patients. They have revolutionized the way we treat rheumatoid arthritis, especially in patients who do not respond to conventional therapies. So, I'm not looking to get rid of this therapy. I want to see it used safely."
Dr. Matteson strongly encourages patients who are prescribed TNF-blocking antibodies for rheumatoid arthritis to be especially alert to symptoms of infection, to get their vaccinations, and to undergo cancer screening appropriate for their age and gender.
Tim Bongartz, M.D., Mayo Clinic rheumatology research fellow who led the study, cautions that this study was not a final, overall risk-benefit analysis for TNF-blocking antibodies.
"Even though we detected an increase in malignancies and serious infections, it does not mean that overall the risks outweigh the benefits for patients," he says. "The short duration of trials included in our analysis does not allow any conclusions about the long-term risks of TNF-blocking antibody treatment in rheumatoid arthritis. It may turn out that the sustained beneficial effect of these drugs on patient mobility and general health will have a significant positive impact on the overall survival of patients."
The researchers hope the unique analysis method used in this study can be used in the future to look for rare, negative events during the course of studies of new drugs, so that the public can be alerted to any risks when the drug comes on the market.
Mayo Clinic
Rheumatoid Arthritis Current Events and Rheumatoid Arthritis News RSSResearchers find new way to attack inflammation in Graves' eye disease
A small group of patients with severe Graves' eye disease experienced rapid improvement of their symptoms - and improved vision - following treatment with the drug rituximab.
Pain thresholds linked to inflammation and sleep problems in arthritis patients
Despite recent advances in anti-inflammatory therapy, many rheumatoid arthritis (RA) patients continue to suffer from pain.
New therapy for vasculitis will help patients avoid infertility and cancer
Researchers have identified that Rituxan, a drug previously approved for the treatment of non-Hodgkin's B cell lymphoma and rheumatoid arthritis, can treat severe ANCA-associated vasculitis as effectively as cyclophosphamide, the current standard therapy.
Strategy for mismatched stem cell transplants triggers protection against graft-vs.-host disease
A new technique being tested in stem-cell transplants from imperfectly matched donors has revealed a striking, unforeseen response that can suppress graft-versus-host disease, a common and dangerous complication of mismatched transplants, report scientists from Dana-Farber Cancer Institute.
Grains and lamb offer new sources of omega-3
CSIRO research on grains and lamb aimed at developing new dietary sources of long-chain omega-3 oils will be presented at the World Congress on Oils and Fats in Sydney this week.
Visionary concept earns La Jolla Institute scientist prestigious NIH Pioneer Award
A scientist at the La Jolla Institute for Allergy & Immunology has received one of the National Institutes of Health (NIH)'s top awards -- the 2009 NIH Director's Pioneer Award.
Experimental approach may reverse rheumatoid arthritis and osteoporosis
Researchers have identified a mechanism that may keep a well known signaling molecule from eroding bone and inflaming joints, according to an early study published online today in the Journal of Clinical Investigation.
Promising new target emerges for autoimmune diseases
University of Michigan scientists say they have uncovered a fundamentally new mechanism that holds in check aggressive immune cells that can attack the body's own cells.
New 'biofactories' produce rare healing substances in the endangered Devil's claw plant
Deep in Africa's Kalahari Desert lies the "Devil's claw," a plant that may hold the key to effective treatments for arthritis, tendonitis and other illnesses that affect millions each year.
Abnormal Brain Circuits May Prevent Movement Disorder
Most people who carry a genetic mutation for a movement disorder called dystonia will never develop symptoms, a phenomenon that has puzzled scientists since the first genetic mutation was identified in the 1990's.
More Rheumatoid Arthritis Current Events and Rheumatoid Arthritis News Articles
 |
The First Year: Rheumatoid Arthritis: An Essential Guide for the Newly Diagnosed (First Year, The) by M.E.A. McNeil (Author), Kenneth Sack MD (Foreword) Rheumatoid arthritis (RA), a disease characterized by inflammation of the joints, is one of the most disabling forms of arthritis and affects over two million people in the United States. Without proper treatment it can lead to long-term joint damage, chronic pain, loss of function, and disability. From the first moment of her diagnosis, author M.E.A. McNeil took charge and educated herself on every aspect of her condition. Now, as a "patient-expert," she guides those newly diagnosed step-by-step through their first year with RA. McNeil provides crucial information about the nature of the disease, treatment options, diet, exercise, social concerns, emotional issues, networking with others, and much more. The First Year—Rheumatoid Arthritis is an essential resource for everyone who wants... |
 |
The New Arthritis Breakthrough: The Only Medical Therapy Clinically Proven to Produce Long-term Improvement and Remission of RA, Lupus, Juvenile RS, Fibromyalgia, ... & Other Inflammatory Forms of Arthritis by Henry Scammell (Author) "...can be miraculous for rheumatoid arthritis sufferers."-- Health & Healing, Tomorrow's Medicine Today |
 |
Living with Rheumatoid Arthritis (Johns Hopkins Press Health Book) by Tammi L. Shlotzhauer MD (Author), James L. McGuire MD (Author), Carol M. Ziminski MD (Foreword) Already a trusted guide and an invaluable resource, Living with Rheumatoid Arthritis offers practical advice for the millions of people who live with this painful disease. Now thoroughly revised and expanded, this second edition brings readers up to date with the latest methods of diagnosis and treatment. Building on their accessible explanation of the disease and its causes, the authors describe the essential components of care: medication, joint protection, physical activity, and good nutrition. They provide a wealth of new information on medications, including biologic response–modifiers, alternative and complementary approaches, and treatments for osteoporosis (which often accompanies rheumatoid arthritis), and they describe safe and effective ways to cope with pain,... |
 |
Synova Total Joint Care with Glucosamine, Chondroitin, MSM for Osteo and Rheumatoid Arthritis - 60 Coated Caplets by Next Nutraceuticals Synova Total Joint Care provides the latest clinically tested ingredients for the body's moveable joints, called synovial joints. The shoulder, elbow, wrist, fingers, hip, knee, ankle and toes are synovial joints. Synova Total Joint Care works to support joint health as well as joint flare-ups.* *Glucosamine HCl - a precursor for glycosaminoglycans, the primary component of joint cartilage. Glucosamine can help rebuild, renew and strengthen synovial joint cartilage.* *Joint Serum (Hyaluronic Acid) - HA is a natural component of synovial fluid found to increase joint viscosity, naturally helping to lubricate and re-hydrate joints.* *Methylsulfonylmethane (MSM) - a naturally occuring sulfur needed to form collagen, which is the protein found in all synovial connective... |
 |
Freedom from Rheumatoid Arthritis: The amazing story of one woman's recovery by Sonia St. Claire (Author) Freedom from Rheumatoid Arthritis is an inspirational book about survival. It tells the story of how one woman went from being a bed ridden cripple on and off for a year and a half, to reclaiming her health, happiness and quality of life stolen from her by this insidious disease. It is the story of a journey, a journey of discovery undertaken by one fiercely determined woman. A woman who has been to the depths and healed herself, and now with consummate compassion and grace, offers to share that process with you. This book includes a seven day menu, recovery and maintenance diet and recipes. |
 |
Rheumatoid Arthritis: The Infection Connection {Targeting and Treating the Cause of Chronic Illness} by Katherine M. Poehlmann (Author) Foreword by Dr. Harold W. Clark, author of "Why Arthritis?" Appendices by Dr. Joseph Mercola (mercola.com) and Dr. Garth Nicolson (Institute for Molecular Medicine) Definitions of terms ****************************** EVERYTHING YOU NEED TO KNOW BEFORE CONSULTING YOUR DOCTOR! ****************************** A research scientist and former arthritis sufferer outlines a proven treatment that could banish your arthritis pain forever. This well-documented study presents evidence that rheumatoid arthritis (RA) and other chronic illnesses are caused by microbial infection. When the infection triggers allergic reactions, it appears that the body's immune system has turned on itself. Once the cause of the infection and allergies are identified and removed,... |
 |
The Arthritis Foundation's Guide to Good Living with Rheumatoid Arthritis, 3rd Edition by Dorothy Foltz-Gray (Author) From the Arthritis Foundation, a trusted source of health information and guidance for more than 50 years, Good Living With Rheumatoid Arthritis, 3rd Edition, explains new research and treatments in clear, simple language. Readers will learn how to be proactive patients, how to stretch daily to reduce pain and increase flexibility, and how to judge the many over-the-counter drugs and supplements on the market today. |
 |
Conquering Arthritis: What Doctors Don't Tell You Because They Don't Know: 9 Secrets I Learned the Hard Way by Barbara D. Allan (Author) This book provides hard-earned, practical, detailed information that is critical for successful healing of arthritis, but that has never before been collected in one book. Without this information many people with arthritis will not get well. The information is organized into a well-researched, easy-to-follow plan for getting well again and includes case histories of people with dramatic and lasting recoveries. It focuses not just on coping with the symptoms of arthritis, but on correcting its underlying causes using proven alternative medicine and pain management techniques. Anyone who is serious about healing from arthritis needs this book. |
 |
What To Do When The Doctor Says It's Rheumatoid Arthritis: Stop Your Pain, Become More Active, and Learn How to Talk to Your Doctors by Winnie Yu (Author), Harry D. Fischer (Author) Rheumatoid arthritis is a painful, incurable connective-tissue disease that attacks the hands, feet, and joints and may lead to deformities and permanent disabilities. This book, written by a doctor and health journalist will offer comprehensive medical advice and lifestyle information for the nearly three million Americans who suffer from this disease. The book uses mind-body techniques and alternative medicine to cope with the pain and discomfort, including information on: Pain relief Exercise Nutrition Managing your relationship with your doctors |
 |
Rheumatoid Arthritis, 2nd Edition by John J. Cush (Author), Michael E. Weinblatt (Author), Arthur Kavanaugh (Author) Emphasizes the importance of early intervention in Rheumatoid Arthritis with focus on pharmacologic treatments of RA. Detailed information on the various medications employed in treatment, including corticosteroids, NSAIDs, DMARDs, biologic agents, and combination therapy, is reviewed, including evidence based data on efficacy, safety, side effects, and monitoring requirements. Clinical evaluation is presented, including lab findings, joint scoring, diagnostic criteria, and radiographic outcomes. Surgical options and the management of advanced RA are discussed. |
| © 2009 BrightSurf.com |