Risk of Infection, Malignancy With Anti-TNF Therapy Unclear

No raised risk in early rheumatoid arthritis patients, naive to methotrexate

FRIDAY, March 11 (HealthDay News) -- Patients with early rheumatoid arthritis taking anti-tumor necrosis factor (TNF) therapy without prior use of disease-modifying anti-rheumatic drugs (DMARD)/methotrexate do not have an increased risk of serious infections or malignancies, according to a meta-analysis published online Feb. 25 in Arthritis & Rheumatism.

Andrew E. Thompson, M.D., from the University of Western Ontario in London, Canada, and colleagues conducted a meta-analysis of six randomized, double-blind, placebo-controlled trials to determine the rates of serious infection and malignancy in patients with early rheumatoid arthritis who started anti-TNF therapy without prior DMARD/methotrexate use. A total of 2,183 patients receiving biologic therapy and 1,236 patients receiving methotrexate therapy were included. The risk of serious infection and malignancy was measured using a pooled odds ratio (OR).

The investigators found that there was a slightly higher, but not statistically significant, risk of serious infections requiring hospitalization (pooled OR, 1.16) and malignancies (pooled OR, 1.07) in patients receiving anti-TNF therapy compared to patients receiving methotrexate (controls).

"This meta-analysis has not shown an increased risk of malignancy or serious infections in newly diagnosed patients with rheumatoid arthritis treated with anti-TNF therapy. However, further review of this population of patients in an observational inception cohort would be important to confirm and strengthen these findings," the authors write.

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