Archive for Info

Two new studies have found no link between an increased risk of cancer and tumor necrosis factor-alpha inhibitors, or anti-TNFs, a type of biologic drug.

las vegas rheumatologistAnti-TNF drugs (otherwise known as tumor necrosis factor-alpha inhibitors) are essential to the treatment of autoimmune diseases such as rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. These drugs work by supressing the immune system to decrease inflammation and the body’s ability to fight infection. Because of this it was believed that these drugs could increase the risk of certain kinds of cancer, such as lymphoma. New research is challenging this belief.

In the first study, a meta-analysis published in the June 2011 Arthritis & Rheumatism, researchers reviewed six trials that included a total of 2,183 RA patients taking anti-TNFs and 1,236 taking methotrexate. The patients all had early-stage RA and had not been previously treated with methotrexate or other disease-modifying anti-rheumatic drugs, or DMARDs. The duration of the trials were between six and 12 months. The analysis found that 19 people taking at least one dose of an anti-TNF, including adalimumab, or Humira; etanercept, or Enbrel; and infliximab, or Remicade, developed a malignancy compared with 10 patients taking methotrexate. Researchers concluded there was no significant difference in risk.

The second study, presented in May at the 2011 European League Against Rheumatism conference in London, looked at more than 13,600 Danish patients, the majority of whom had RA, from the DANBIO registry, a nationwide database that includes all rheumatic patients receiving biological drugs. From January 2000 to the end of 2008, almost 5,600 of them had started anti-TNF treatment.

The researchers cross-referenced data from DANBIO registry with the Danish Cancer Registry and found that 181 patients ever treated with an anti-TNF developed cancer compared to 132 patients who had not taken an anti-TNF. The researchers concluded there was no statistical difference in cancer risk. After further analyzing the data, the researchers also concluded that the risk of cancer did not rise with longer-term use of anti-TNFs.

Previous research has shown that people with RA, independent of medication use, have a higher risk of cancer than people without the disease. This is possibly due to chronic stimulation of the immune system. Thus the patients who have the most significant disease activity, are more likely to receive anti-TNF agents. These people were more likely to get cancer to begin with.

A 2009 study came to similar conclusions. One of the largest and longest population-based assessments of cancer risks associated with immunosuppressive therapy, published in Arthritis & Rheumatism in 2009, compared cancer rates among more than 75,000 RA patients in Sweden who were taking either no medications, methotrexate, anti-TNF therapies or other DMARDs. In the six-year period they analyzed, the researchers found the risk of developing cancer was the same for people on anti-TNF medications as those in the other groups.

Overall, this is reassuring news to patients. For the vast majority of patients, the benefits of these drugs outweigh the potential risks. They can mean a patient can have an excellent quality of life for years to come.


Categories : Info

The Prevalence of Arthritis is on the Rise

Wednesday, August 3rd, 2011

Henderson, Nevada RheumatologistA new study from CDC reports that 50 million U.S. adults had arthritis in 2007-2009, an increase from 2003–2005 (46 million). This new estimate is in line to match future projected prevalence estimates of 67 million by the year 2030 and suggest that the number of adults with arthritis is growing by almost 1 million per year. The study also reports more than 21 million (42% of adults with arthritis) reported having activity limitations because of their arthritis. This estimate is higher than expected on the basis of future projected estimates of 25 million by 2030.

Obesity may be a special problem in arthritis; 1 in 3 obese adults report having arthritis. Obesity is associated with incident knee osteoarthritis (OA), disease progression, disability, total joint replacement, and poor clinical outcomes after joint replacement and likely has a critical role in the increasing population burden and impact of arthritis. Even small amounts of weight loss (approximately 11 lbs) may cut the risk of getting knee osteoarthritis by 50% and may reduce mortality risk in patients with osteoarthritis.

This study analyzed three years of data from the National Health Interview Survey, which interviews a sample of civilian, non-institutionalized U.S. population of all ages. The extra years of data allowed CDC to update previous estimates of arthritis prevalence and arthritis-attributable activity limitation and to analyze the prevalence of arthritis by body mass index categories.

Cheng YJ, Hootman JM, Murphy LB, Langmaid GA, Helmick CG. Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation — United States, 2007–2009. MMWR 2010;59(39):1261–1265

Categories : Info