TNF inhibitor side effects in rheumatoid arthritis studied
Patients with rheumatoid arthritis treated with tumour necrosis factor (TNF) inhibitors may be at an increased risk of serious infection or malignancy, according to a meta-analysis published in JAMA (2006;295:2275).
The researchers analysed adverse event data from nine studies with a
total of 3,493 patients treated with a TNF inhibitor (infliximab or adalimumab)
and 1,512 patients given placebo. They found a greater likelihood of
malignancy in patients taking high-dose TNF inhibitors (pooled odds ratio
4.3, 95 per cent confidence interval 1.6–11.8) and in those taking
low-dose TNF inhibitors (1.4, CI 0.3–5.7), versus placebo. There
was a significant difference in the risk of malignancy between the high-dose
and low-dose groups (3.5, CI 1.4–8.2). Patients treated with TNF
inhibitors were also more likely to have a serious infection than those
in the placebo group (2.0, CI 1.3–3.1).
However, the authors say that the reduction of joint destruction, gain
in mobility and increase in quality of life must be carefully considered
when looking at the risks and benefits of using TNF inhibitors for individual
patients, especially those with rheumatoid arthritis who failed to respond
to treatments before these agents became available. |
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