Newer biologic treatments for Rheumatoid Arthritis (RA), including infliximab , adalimumab, certoilizumab pegol, golimumab and etanercept, do not increase the risk of cancer, concluded a nine year Danish registry study presented at the Annual Congress of the European League Against Rheumatism, (EULAR) London, UK, 25-28 May 2011.

"TNF is a small signalling molecule called a cytokine and is able to inhibit the development of tumours by interfering with signalling pathways. Therefore drugs targeting TNF can influence the development of tumours, although the extent of this impact remains unclear," said Lene Dreyer, the principal author of the study, from the Department of Rheumatology at Gentofte University Hospital (Denmark).

The study was based on the national Danish DANBO registry, which was initiated in 2000 to monitor the treatment of biologic medicines in Denmark. The DANBO registry included 13,699 patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis, of which 5,598 patients had started anti-TNF treatment. The incidence of cancer among patients treated with anti-TNF agents was compared to the incidence among patients not treated by evaluating relative risks.

The results showed that the relative risk was not increased in patients treated with antiTNFs compared with patients who had never taken anti-TNFs during 23,965 person year follow ups (RR=1.03). The risk of developing cancer was not shown to increase with time post initiation of anti-TNF therapy (p=0.51), nor with duration of anti-TNF therapy (p=0.19) and was shown to be independent of the type of anti-TNF agent received (p=0.99)

"This study provides long term evidence that an overall risk of cancer is not associated with this group of treatment," concluded Dreyer.

Reference: L Dreyer, L Mellemkjaer, ML Hetland et al. No increase cancer risk in patients with rheumatoid arthritis, psoriatic arthritis or other arthritides treated with anti-tumour necrosis factor agents – a long-term follow-up study from the nationwide Danish DANBIO registry. EULAR. Abstract FRI0203.