Friday, 27 Mar 2020

You are here

TNF Inhibitors Don't Increase Cancer Risk in Children

 

While the risk of neoplasia with tumour necrosis factor inhibitor (TNFi) use has been largely nullified in most inflammatory disorders, this risk in children is less certain. However a recent study shows no risk of increased cancer in children treated with TNFi for juvenile idiopathic arthritis (JIA), pediatric inflammatory bowel disease (pIBD) and pediatric plaque psoriasis (pPsO).

A retrospective US of administrative claims data from 2000 to 2014 compared 15,598 children on TNFi and 73,839 children not exposed to TNFi  who had JIA, pIBD or pPsO.

A totl of 15 malignancies were seen with TNFi use (SIR 2.9 ; 95%CI 1.6 to 4.9) compared with  42 without TNFi exposure (SIR 2.1; 1.5 to 2.9). The adjusted Hazard Ration  was 1.58 (0.88 to 2.85) for TNFi use versus no TNFi use.

Only in pIBD did the combined use of TNFi with a thiopurine result in a higher SIR (6.0 (1.2 to 17.5)) compared with TNFi use without thiopurine use (2.5 (0.7 to 6.4)).

 

Disclosures: 
The author has received compensation as an advisor or consultant on this subject

Add new comment

More Like This

Start with Anti-TNF in RA? Not So Fast

The suggestion to hit rheumatoid arthritis (RA) early and hard with biologic therapies itself took a hit in a new study.

Use of first-line etanercept (Enbrel) plus methotrexate in very early RA was not associated with a substantially higher rate of remission compared with a strategy of treat-to-target methotrexate monotherapy, a randomized open-label trial found.

Best of 2019 - The Shame Behind Adalimumab Biosimilars

JAMA has an article this week on the shift from biologic drugs to less expensive therapeutic biosimilar agents. The impact of biosimilars can be easily represented by the shift from adalimuamb - a biologic with nearly $19 billion in sales in 2018 - to any one of the four FDA approved biosimilars for adalimumab (see the daily download for slides on new adalimumab and other biosimilars).

Psoriasis Risk Increased with TNF Inhibitors in Juveniles

Children with inflammatory diseases who were treated with tumor necrosis factor (TNF) inhibitors had a higher rate of incident psoriasis than those not exposed to these biologics, a single-center retrospective study found.

The Shame Behind Adalimumab Biosimilars

JAMA has an article this week on the shift from biologic drugs to less expensive therapeutic biosimilar agents. The impact of biosimilars can be easily represented by the shift from adalimuamb - a biologic with nearly $19 billion in sales in 2018 - to any one of the four FDA approved biosimilars for adalimumab (see the daily download for slides on new adalimumab and other biosimilars).

Pain Persists Despite TNF Inhibitor Use

Control of pain in patients with rheumatoid arthritis (RA) often focuses on control of inflammation as a means to better control pain. However, a new claims data study shows that while anti-tumor necrosis factor inhibitor (TNFi) may lower the use of opioids, the reduction is nominal, suggesting that a substantial amount of pain is not adequately addressed by TNFi - a potent anti-inflammatory approach.