Cancer Risk from Anti-TNF Drugs

Many people with autoimmune disorders take tumor necrosis factor inhibitors, also called anti-TNF or TNFis, which are drugs that reduce inflammation by blocking TNF proteins. These medications — which include adalimumab (Humira), etanercept (Enbrel), and infliximab (Remicade), among others — help control disease activity, but as with all drugs there are risks and side effects.

Experts have been especially concerned that they might increase the risk of cancer, though research has been mixed. Now a new study, presented at the annual European Congress of Rheumatology (EULAR 2019) in Madrid, largely puts those fears to rest for psoriatic arthritis (PsA) patients, though some questions remain.

The study, an analysis of data on over 8,000 PsA patients from Sweden, Denmark, Iceland, and Finland who had used TNFis, found that there was no overall increase in cancer cases versus what’s expected in the general population. Researchers also determined that PsA patients who used TNFis were no more likely to develop specific cancers including lung, melanoma, pancreatic, brain, endometrial, and breast.

While that’s reassuring, the news isn’t all good: The authors found that PsA patients who used TNFis were significantly more likely to develop lymphoma. They were nearly twice as many cases of lymphoma compared to the number that’s expected in the general population.

This doesn’t necessarily mean that TNF inhibitors cause lymphoma, since other factors — including having an autoimmune disease (in this case, PsA) in the first place — might play an important role in cancer development. More research will be needed to further investigate this association.

“TNF inhibitors have a well-established efficacy and safety profile in patients with psoriatic arthritis and we welcome these data which contribute to our understanding in the complex area of cancer risk,” said Professor Hans Bijlsma, president of EULAR, in a press release.

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