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Current Rheumatology Reports
Published in: Current Rheumatology Reports 6/2012

01-12-2012 | VASCULITIS (LR ESPINOZA, SECTION EDITOR)

TNF-α Blocker Therapy and Solid Malignancy Risk in ANCA-Associated Vasculitis

Authors: Francisco Silva, Marcela Cisternas, Ulrich Specks

Published in: Current Rheumatology Reports | Issue 6/2012

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Abstract

ANCA-associated vasculitides (AAV) are small vessel systemic vasculitis syndromes associated with the potential for high morbidity and mortality. This group includes granulomatosis with polyangiitis (Wegener´s, GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (Churg-Strauss, EGPA). The standard treatment consists of a combination of glucocorticoids and potent immunosuppressant drugs. These have broad mechanisms of action as well as important adverse effects. Efforts have been made to investigate novel agents with better-defined and narrower mechanisms of action, such as biologics, including TNF-α blockers. Etanercept, a well-known TNF-α blocker evaluated for GPA in the Wegener’s Granulomatosis Etanercept Trial (WGET), was associated with an increase in the development of solid malignancies in comparison to placebo during that trial period. A 5-year follow-up after the WGET trial showed a sustained increase in incidence of solid malignancies, but this could no longer be solely attributed to etanercept exposure. These studies raised concerns about the use of the family of TNF-α blockers in AAV. Here, we review the evidence about the association between therapeutic inhibition of tumor necrosis factor (TNF-α) by etanercept and other TNF-α blockers with the development of solid malignancies in GPA and other AAV.
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Metadata
Title
TNF-α Blocker Therapy and Solid Malignancy Risk in ANCA-Associated Vasculitis
Authors
Francisco Silva
Marcela Cisternas
Ulrich Specks
Publication date
01-12-2012
Publisher
Current Science Inc.
Published in
Current Rheumatology Reports / Issue 6/2012
Print ISSN: 1523-3774
Electronic ISSN: 1534-6307
DOI
https://doi.org/10.1007/s11926-012-0290-2

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