Tumour necrosis factor blockers do not increase overall tumour risk in patients with rheumatoid arthritis, but may be associated with an increased risk of lymphomas

Geborek, Pierre; Bladström, Anna; Turesson, Carl; Gülfe, Anders; Petersson, Ingemar F; Saxne, Tore; Olsson, Håkan; Jacobsson, Lennart

doi:10.1136/ard.2004.030528

Cited by 393 publications

(264 citation statements)

References 33 publications

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“…146 Controversy remains with regard to whether the observed higher incidences indicate additional risk due to TNF treatment, or whether they are in line with the increased risk of lymphoma observed in RA patients with high inflammatory activity. [147][148][149][150][151] In general, the incidence of other types of malignancies in TNF inhibitor-treated patients was found to be similar to, or lower than that observed in the general population 146,152,153 and other RA populations.…”

Section: Malignancies Including Lymphomasmentioning

confidence: 99%

A systematic review of the effectiveness of adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis in adults and an economic evaluation of their cost-effectiveness

Chen

Jobanputra

Barton

et al. 2006

Health Technol Assess

322

261

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email.Paying by official purchase order You can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. Declared competing interests of authors: P Jobanputra is a Consultant Rheumatologist and a member of the British Society for Rheumatology. He has received funding for educational purposes from Abbott and Wyeth and has been entertained by manufacturers of all three TNF inhibitors. He has been involved in research studies of adalimumab and etanercept for rheumatoid arthritis and his department has received funding from Wyeth and Abbott for these studies. HTA Published November 2006This report should be referenced as follows:Chen Y-F, Jobanputra P, Barton P, Jowett S, Bryan S, Clark W, et al. A systematic review of the effectiveness of adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis in adults and an economic evaluation of their cost-effectiveness. Health Technol Assess 2006;10(42). Health Technology Assessment is indexed and abstracted in Index Medicus/MEDLINE, Excerpta Medica/EMBASE and Science Citation Index Expanded (SciSearch ® ) and Current Contents® /Clinical Medicine. NHS R&D HTA ProgrammeT he research findings from the NHS R&D Health Technology Assessment (HTA) Programme directly influence key decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC) who rely on HTA outputs to help raise standards of care. HTA findings also help to improve the quality of the service in the NHS indirectly in that they form a key component of the 'National Knowledge Service' that is being developed to improve the evidence of ...

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Section: Malignancies Including Lymphomasmentioning

confidence: 99%

A systematic review of the effectiveness of adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis in adults and an economic evaluation of their cost-effectiveness

Chen

Jobanputra

Barton

et al. 2006

Health Technol Assess

322

261

View full text Add to dashboard Cite

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“…However, blocking studies targeting BLyS and APRIL have revealed that both pro-and antiinflammatory mechanisms depend on these cytokines (22). Also, it is unlikely that TNF␣ itself is a lymphoma-promoting factor, since the risk of lymphoma development appears to be higher, not lower, in patients treated with TNF␣-blocking agents (23,24).…”

mentioning

confidence: 99%

Lymphoma in rheumatoid arthritis: An immune system set up for failure

Weyand

Goronzy

Kurtin

2006

Arthritis & Rheumatism

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“…75 Bu sonuç-lar baflka bir çal›flma grubunun yapm›fl oldu¤u çal›flma ile de desteklenmifl ve lenfoma d›fl›nda malignite s›kl›-¤›n›n bu ajanlar ile artmad›¤›n› ortaya koymufltur. 76 Ancak, TNF antagonisti kullan›lan hasta grubunda ki 5 lenfoma vakas› ile standart s›kl›k oran› 11,5 ulafl›rken, di¤er tedaviler ile 2 lenfoma vakas›n›n 1,3 standart s›kl›k oran› ile sonuçland›¤›n› ortaya koymufltur. Yazarlar, bu sonuçlar› yorumlarken RA hastalar›nda biyolojik ajan kullan›m›n›n genellikle klasik tedavilere dirençli olgularda gerekti¤ini ve bu hastalarda artm›fl lenfoma riskinin gozden kaç›r›lmamas› gerekti¤ini belirtmifllerdir.…”

Section: Tnf Antagonistleriunclassified

“…Ayr›ca yazarlar bir gözlem olarak belirttikleri artm›fl herpes enfeksiyonlar› sebebiyle, bu hastalarda olas› bir artm›fl EBV enfeksiyon riskinin araflt›r›lmas› gerekti¤ini belirtmifllerdir. 76 Ancak bu konuda yap›lan çal›flmalar da EBV yükü-nün RA hastalar›nda artt›¤›n› gösteren çal›flmalar oldu¤u gibi 77 , kontrol grubuna göre de¤iflmedi¤ini gösteren yay›nlarda mevcuttur. 78 TNF-alfa blokörlerinin ve metotreksat kullan›m›n›n serumdaki EBV yüküne etkisinin araflt›r›ld›¤› bir çal›flmada her iki tedavi ile de serum virüs yükünün 12 hafta içinde de¤iflmedi¤i gösterilmifl-tir.…”

Section: Tnf Antagonistleriunclassified

New Treatment Alternatives in the Management of Non-İnfectious İntraocular İnflammations: Biologic Agents

Emre¹,

Tutkun²

2011

tjo

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ÖzetEnfeksiyöz olmayan üveitlerin tedavisinde son y›llara kadar genel olarak immün sistemi bask›layan ilaçlar kullan›lmak-tayd›. Ancak gen mühendisli¤indeki geliflmeler, inflamatuar süreçte yer alan özgün molekülleri hedefleyen proteinlerin sentezini ve bu proteinlerin terapötik olarak kullan›lmalar›n› mümkün k›lm›flt›r. Genel olarak protein yap›s›ndaki bu ajanlar biyolojik ajanlar olarak adland›r›lm›fllard›r. Oftalmologlar›n biyolojik ajanlar ile tecrübeleri s›n›rl› olsa da, bu ajanlar romatoloji ve dermatoloji baflta olmak üzere di¤er disiplinler taraf›ndan yo¤un biçimde kullan›lmaktad›rlar. ‹nterferon, infliksimab ve adalimumab baflta olmak üzere birçok biyolojik ajan›n üveit hastalar›nda kullan›m› ile ilgili literatür verisi olmas›na ra¤men henüz bu endikasyonda ruhsatl› kullan›mlar› yoktur. Ayr›ca bu ajanlar›n kullan›m› s›ras›nda dikkat edilmesi gereken güvenlik önlemleri ve önemli risk faktörleri mevcuttur. Bu derlemenin amac›, dirençli üveit hastalar›nda kullan›labilen biyolojik ajanlar konusunda güncel ve kapsaml› bilgi sunmakt›r. ( SummaryConventional immunosuppressive agents have been traditionally used for the treatment of noninfectious uveitis. Recent developments in genetic engineering have made it possible to synthesize proteins that target specific molecules playing role in the inflammatory response. These agents are generally in protein structure and are named biologic agents. While there is limited experience with biologics in the field of ophthalmology, they are commonly used in other disciplines such as rheumatology and dermatology. Although considerable data have accumulated in the uveitis literature regarding the use of biologic agents, including mainly interferon, infliximab, and adalimumab, their use for this indication is still off-label. Moreover, there are certain precautions that have to be taken into account, as well as important safety issues associated with their use. The purpose of this paper is to present an updated comprehensive review of biologic agents that may be used for the treatment of refractory uveitis. (Turk J Ophthalmol 2011; 41: 243-55 GiriflEnfeksiyöz olmayan üveitlerin tedavisinde kullan›lmakta olan immunsupresan ajanlar, ba¤›fl›kl›k sistemini genel olarak bask›lamakta veya sapt›rmaktad›rlar. Bu tedavi yöntem-lerinin sebep olduklar› ciddi yan etkiler ile tedaviye dirençli olgular, hekimleri yeni tedavi aray›fllar›na itmektedir. Son y›llarda araflt›r›lan biyolojik ajanlar, inflamatuar süreçteki öz-gün molekülleri (proteinleri) etkileyerek ba¤›fl›kl›k sisteminde daha s›n›rl› ancak etkin bir tedavi sa¤lamaktad›rlar. Biyolojik ajanlar, moleküler rekombinant DNA teknolojisi kullan›larak elde edilen proteinlerdir. Bu ajanlar›n büyük ço¤un-lu¤u monoklonal antikorlard›r. fiu an için enfeksiyöz olmayan üveitlerin tedavisinde bafll›ca kullan›lan biyolojik ajanlar 3 grupta s›n›fland›r›labilir; i. Interferon-α, ii. TNF-α antagonistleri ve iii. Çeflitli sitokin veya yüzey membran proteini gibi farkl› hedeflere yönelik antikorlar veya füzyon proteinleri.

show abstract

Tumour necrosis factor blockers do not increase overall tumour risk in patients with rheumatoid arthritis, but may be associated with an increased risk of lymphomas

Cited by 393 publications

References 33 publications

A systematic review of the effectiveness of adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis in adults and an economic evaluation of their cost-effectiveness

A systematic review of the effectiveness of adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis in adults and an economic evaluation of their cost-effectiveness

Lymphoma in rheumatoid arthritis: An immune system set up for failure

New Treatment Alternatives in the Management of Non-İnfectious İntraocular İnflammations: Biologic Agents

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