Risk of Serious Infections and Malignancies With Anti-TNF Antibody Therapy in Rheumatoid Arthritis

A systematic review of infliximab in the treatment of early rheumatoid arthritis

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The effectiveness and safety of adalimumab in the treatment of non‐reimbursed patients with mild‐to‐moderate psoriasis

“…Dr Bongartz and colleagues conducted meta‐analysis of randomized clinical trials of infliximab and adalimumab, and found increased risk of serious infection and malignancy with their use 39 . However, the results have been criticized for not adjusting for duration of exposure and not including etanercept 40–42 . Risks of lymphoma 17,43 and solid cancers 17,18 associated with anti‐TNF treatment remain controversial.…”

British Association of Dermatologists’ guidelines for biologic interventions for psoriasis 2009

“…The data included 3493 patients who received TNF antagonist treatment and 1512 patients who received placebo and demonstrated a pooled odds ratio for malignancy of 3·3 (95% CI 1·2–9·1). This paper raised a variety of methodological concerns 128–130 which included lack of adjustment for duration of exposure to TNF antagonist therapy, inclusion of open‐label extension data for biologic therapy with no comparable placebo data, infliximab induction doses exceeding labelled dose in approximately 50% of patients and an unexpectedly low rate of malignancy in the control arms. In addition, both infliximab and adalimumab have been rarely associated with hepatosplenic T‐cell lymphoma 131 .…”