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Study: Rheumatoid-arthritis drugs may raise cancer, infection risk

May 17, 2006 | South Florida Sun-Sentinel

Some drugs used to treat rheumatoid arthritis, a devastating disease that can deform bone and cause extreme pain, may increase the risk for serious infections and also some cancers in rare cases, according to an analysis of nine studies involving the drugs.

But doctors familiar with the research say the benefits of the drugs, Humira and Remicade, outweigh the risks for most people with rheumatoid arthritis.

The best course of action, they say, is for doctors to monitor their patients closely for symptoms of infection or cancer. Enbrel, a similar drug, was not included in the analysis, but a separate study is planned.

Rheumatoid arthritis affects more than 2 million Americans. It occurs when the body's immune system malfunctions and attacks joints anywhere in the body. It is a different disease from osteoarthritis, which affects 21 million Americans and begins with the breakdown of joint cartilage, causing pain and stiffness.

More than a half-million rheumatoid-arthritis patients have received therapy with the drugs so-called TNF-blocking antibodies -- which can halt the body's production of a protein that can cause inflammation. The drugs can improve range of movement, ease pain, and may increase life expectancy.

Dr. Eric Matteson, a Mayo Clinic rheumatologist who worked on the analysis published in today's Journal of the American Medical Association, said that as the drugs slow the progression of rheumatoid arthritis, they also can interfere with normal immune function.

Of 3,493 patients in the nine clinical trials who received at least one drug treatment, 29 developed cancers, compared with only three cancers in 1,512 patients who took a placebo. Serious infections, such as pneumonia, occurred in 126 patients on the drugs, compared with 26 infections in people who took placebos.

"Most of the patients appropriate for this therapy do not have other good options," Matteson said. "TNF-blocking antibodies are absolutely the best drug for many patients."