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Anti-TNF Antibody Therapy May Boost Infection, Cancer Risk

Meta-analysis shows increased risk of infections, malignancies in rheumatoid arthritis patients

THURSDAY, May 18 (HealthDay News) -- Anti-tumor necrosis factor (anti-TNF) antibody therapy may increase the risk of serious infections in patients with rheumatoid arthritis, and there is a dose-dependent increase in risk of malignancies, according to a study published in the May 17 issue of the Journal of the American Medical Association.

Tim Bongartz, M.D., of the Mayo Clinic College of Medicine in Rochester, Minn., and colleagues conducted a meta-analysis of nine randomized, placebo-controlled trials of the two licensed anti-TNF antibodies (infliximab and adalimumab) which included 3,493 rheumatoid arthritis patients who received therapy and 1,512 rheumatoid arthritis patients who received placebo.

The researchers estimated effects for high and low doses separately and found that the pooled odds ratio was 2.0 for serious infection and 3.3 for malignancy. They also found that malignancies were significantly more common in patients receiving higher doses compared to those receiving lower doses (OR, 4.3 versus 1.4).

"Our analysis contributes to the findings that challenge the previously presumed safety profile of anti-TNF therapy," the authors state. "The detected increase of two serious adverse events has to be interpreted in the light of the high effectiveness of anti-TNF therapy in patients with rheumatoid arthritis and the lack of therapeutic alternatives in cases with high disease activity irresponsive to traditional disease-modifying anti-rheumatic drug therapy."

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