European League Against Rheumatism 2011 Annual European Congress of Rheumatology, May 25-28, 2011
The European League Against Rheumatism 2011 Annual European Congress of Rheumatology was held from May 25 to 28 in London and attracted more than 15,000 participants from around the world, including scientists, physicians, and allied health professionals. The conference highlighted recent advances in the prevention, detection, and treatment of rheumatic diseases of the connective tissue, locomotor, and musculoskeletal systems. The conference featured nearly 300 oral and more than 1,600 poster abstract presentations, with approximately 300 speaker lectures taking place in more than 140 sessions.
In one study, Lene Dreyer, M.D., Ph.D., of the Copenhagen University Hospital in Denmark, and colleagues found that long-term use of anti-tumor necrosis factor (TNF) agents was not associated with an increased overall risk of cancer. The investigators used data from the nationwide Danish DANBIO registry and Danish Cancer Registry.
Over nine years of follow-up, the investigators found that the relative risk of cancer was not increased in patients treated with anti-TNF agents as compared with patients never given anti-TNF agents.
"We were relieved to see that biologics did not increase the overall risk of cancer in this patient population," Dreyer said. "We will continue to study the occurrence of cancer in our cohort as follow-up is increasing and new biological treatment drugs are introduced. We are also planning to study the risk of eventual relapse or secondary cancer in Danish arthritis patients who have received treatment with biologics after a first cancer diagnosis."
One author disclosed financial relationships with multiple pharmaceutical companies that manufacture anti-TNF agents.
In an observational study, Paul Emery, M.D., of Leeds University in the United Kingdom, and colleagues found that there was no significant difference in mortality risk associated with an anti-TNF agent, etanercept, or disease modifying anti-rheumatic drugs (DMARDs). The investigators compared mortality rates of 3,431 patients treated with etanercept and 1,365 treated with DMARDs. Although mortality rates were lower among those who received etanercept (1.31 percent) as compared with those received DMARDs (2.27 percent), the difference did not reach statistical significance in the more conservative scenarios modeled.
"Although adjusted for baseline differences, other confounding factors may have influenced these findings," the authors write.
Several authors disclosed financial relationships with Pfizer, the manufacturer of etanercept (Enbrel), as well as with other pharmaceutical companies, including Abbott, a manufacturer of DMARDs and anti-TNF agents.
Nasim Khan, M.D., of the University of Arkansas for Medical Sciences in Little Rock, and colleagues found that randomized controlled trials (RCTs) of rheumatoid arthritis treatments were more likely to have positive outcomes when investigators received consulting fees or honoraria from the pharmaceutical industry.
"Financial conflicts of interests [FCOIs] among authors of RCTs of drug therapy are common, and some have shown an increased temporal trend in reporting," Khan said.
The investigators found that RCTs that had authors who had received consultancy fees/honoraria from the study's experimental drug manufacturer were more likely to have positive outcomes than those without such FCOIs (91 versus 66.7 percent). The association remained positive after adjusting for potential confounding RCT characteristics such as funding source, RCT quality score, and number of study participants.
"This is a cross-sectional study, and the cause for increased positive outcomes with certain FCOIs cannot be precisely ascertained," Khan said. "However, the possible reasons could be that their expertise leads to studies that are more likely to be successful; publication bias (studies with positive [results] having higher likelihood of publication); study design factors (more likelihood of using placebo rather than appropriate active comparator drug); and the discomforting possibility that some investigators may be swayed by the financial benefits from the pharmaceutical industry."
Jesper Lindhardsen, M.D., of the Gentofte University Hospital in Copenhagen, Denmark, and colleagues found that rheumatoid arthritis (RA) patients were significantly less likely to be prescribed standard myocardial infarction (MI) treatments after their first heart attack as compared to healthy controls.
The investigators evaluated 1,113 RA patients' prescriptions between their first MI and 30 and 180 days following to determine whether standard MI treatments had been prescribed. At 30 days, as compared to healthy controls, RA patients were approximately 20 percent less likely to be prescribed standard MI treatments, including statins and beta blockers, with these findings remaining relatively unchanged at 180 days.
"Previous research has established that RA patients have an increased risk of cardiovascular disease (CVD). The results of our study suggest that CVD may be undertreated in these patients, due to concerns regarding the use of multiple medications or patient compliance," Lindhardsen said in a statement. "Clinicians may find post-MI treatment in RA patients more complicated, which would explain the lower propensity towards prescribing treatment; however, this may be increasing the CVD burden seen in RA patients. Additional research is required in this area to establish whether further education is needed."