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Arthritis Research & Therapy
Published in: Arthritis Research & Therapy 5/2006

01-10-2006 | Commentary

Is there an association between anti-TNF monoclonal antibody therapy in rheumatoid arthritis and risk of malignancy and serious infection? Commentary on the meta-analysis by Bongartz et al

Authors: Will Dixon, Alan Silman

Published in: Arthritis Research & Therapy | Issue 5/2006

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Abstract

A recent meta-analysis of randomized clinical trials reported by Bongartz and coworkers raised concerns about an increased rate of malignancy and serious infection in rheumatoid arthritis patients treated with anti-tumour necrosis factor monoclonal antibodies. This commentary discusses some of the methodological issues in their analysis and urges caution in interpreting the results.
Literature
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Bongartz T, Sutton AJ, Sweeting MJ, Buchan I, Matteson EL, Montori V: Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serious infections and malignancies: systematic review and meta-analysis of rare harmful effects in randomized controlled trials. JAMA. 2006, 295: 2275-2285. 10.1001/jama.295.19.2275.CrossRefPubMed
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Brown SL, Greene MH, Gershon SK, Edwards ET, Braun MM: Tumor necrosis factor antagonist therapy and lymphoma development: twenty-six cases reported to the Food and Drug Administration. Arthritis Rheum . 2002, 46: 3151-3158. 10.1002/art.10679.CrossRefPubMed
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Wolfe F, Michaud K: Lymphoma in rheumatoid arthritis: the effect of methotrexate and anti-tumor necrosis factor therapy in 18,572 patients. Arthritis Rheum. 2004, 50: 1740-1751. 10.1002/art.20311.CrossRefPubMed
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Askling J, Fored CM, Baecklund E, Brandt L, Backlin C, Ekbom A, Sundstrom C, Bertilsson L, Coster L, Geborek P, et al: Haematopoietic malignancies in rheumatoid arthritis: lym-phoma risk and characteristics after exposure to tumour necrosis factor antagonists. Ann Rheum Dis. 2005, 64: 1414-1420. 10.1136/ard.2004.033241.PubMedCentralCrossRefPubMed
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Symmons DP, Silman AJ: Anti-tumor necrosis factor alpha therapy and the risk of lymphoma in rheumatoid arthritis: no clear answer. Arthritis Rheum. 2004, 50: 1703-1706. 10.1002/art.20312.CrossRefPubMed
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Baecklund E, Iliadou A, Askling J, Ekbom A, Backlin C, Granath F, Catrina AI, Rosenquist R, Feltelius N, Sundstrom C, et al: Association of chronic inflammation, not its treatment, with increased lymphoma risk in rheumatoid arthritis. Arthritis Rheum . 2006, 54: 692-701. 10.1002/art.21675.CrossRefPubMed
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Listing J, Strangfeld A, Kary S, Rau R, von Hinueber U, Stoyanova-Scholz M, Gromnica-Ihle E, Antoni C, Herzer P, Kekow J, et al: Infections in patients with rheumatoid arthritis treated with biologic agents. Arthritis Rheum. 2005, 52: 3403-3412. 10.1002/art.21386.CrossRefPubMed
8.
Dixon WG, Watson K, Lunt M, Hyrich KL, British Society for Rheumatology Biologics Register Control Centre Consortium, Silman AJ, Symmons DPM, on behalf of the British Society for Rheumatology Biologics Register: Serious infection rates, including site-specific and bacterial intracellular infection rates, in rheumatoid arthritis patients treated with anti-TNFα therapy: Results from the British Society for Rheumatology Biologics Register (BSRBR). Arthritis Rheum. 2006, 54: 2368-2376. 10.1002/art.21978.CrossRefPubMed
Metadata
Title
Is there an association between anti-TNF monoclonal antibody therapy in rheumatoid arthritis and risk of malignancy and serious infection? Commentary on the meta-analysis by Bongartz et al
Authors
Will Dixon
Alan Silman
Publication date
01-10-2006
Publisher
BioMed Central
Published in
Arthritis Research & Therapy / Issue 5/2006
Electronic ISSN: 1478-6362
DOI
https://doi.org/10.1186/ar2026

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