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  • Publication # 14-RA004

Tumor necrosis factor inhibitors not shown to raise short-term cancer risk of patients with chronic inflammatory disorders

Chronic Disease

Biologicals designed to inhibit tumor necrosis factor (TNF) activity have become important components of the treatment of inflammatory disorders, particularly rheumatoid arthritis, inflammatory bowel disease (Crohn's disease and ulcerative colitis), psoriasis, psoriatic arthritis, and ankylosing spondylitis. TNF inhibitors (e.g., etanercept, infliximab, and adalimumab) neutralize the cytokine TNF, which has multiple roles in the body and can destroy cells of certain cancers. 

Some studies have suggested that treatment with TNF inhibitors might increase the risk of cancer among patients with these inflammatory diseases. However, other studies have found no such increase with TNF-inhibitor therapy. A new comparative safety study did not find that short-term risk of common cancers was any higher among patients treated with TNF inhibitors than among patients receiving other common therapies for these immune-mediated chronic inflammatory diseases. Commonly used therapies varied depending on the condition being treated but included hydroxychloroquine, methotrexate, topical steroids and retinoids, and ulraviolet light. 

The study drew on national Medicaid and Medicare databases, pharmaceutical assistance programs in New Jersey and Pennsylvania, and data from Kaiser Permanente Northern California. The analysis included 29,555 patients with rheumatoid arthritis, 6,357 patients with inflammatory bowel disease, 1,298 patients with psoriasis, and 2,498 patients with psoriatic arthritis. This study was funded by AHRQ (HS17919). 

See "Tumor necrosis factor inhibitor therapy and cancer risk in chronic immune-mediated diseases," by Kevin Haynes, Pharm.D., Timothy Beukelman, M.D., Jeffrey R. Curtis, M.D., and others in Arthritis & Rheumatism 65(1), pp. 48-58, 2013.


Page last reviewed February 2014
Internet Citation: Tumor necrosis factor inhibitors not shown to raise short-term cancer risk of patients with chronic inflammatory disorders: Chronic Disease. February 2014. Agency for Healthcare Research and Quality, Rockville, MD.


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