Can RA Medications Increase Skin Cancer Risk?

Medications used to help treat Rheumatoid Arthritis such as Enbrel and Remicade are in the category of TNF (tumor necrosis factor) inhibitors. New research suggests that such medications may increase skin cancer, including the commonly known skin cancer, melanoma. Such findings come from recent meta-analysis and review of previously published research concerning medications used for arthritis treatment.

For the thousands of people currently suffering from various types of arthritis and may be currently taking TNF inhibitor medications should be aware of the significant risks that are involved with taking such medications, regardless of how helpful they may seem. For people who suffer from Rheumatoid Arthritis, cells known as follicular dendritic cells use tentacle like mechanisms to attach themselves to B cells which are essential in helping the immune system fight off inflammation and infection. Since patients with Rheumatoid Arthritis have B cells that are corrupted by these follicular dendritic cells, their B cells are not able to properly function for the immune systems and therefore directly impact the existence of rheumatoid arthritis.

TNF type inhibitors work to disrupt the corruption that the follicular dendritic cells cause and therefore reduce the number of faulty B cells in the body which as a result can reduce pain and inflammation linked to Rheumatoid Arthritis. While these medications are exceptionally helpful in helping treat the symptoms of Rheumatoid Arthritis. Unfortunately, these medications also could increase skin cancer risk for those taking them.

Researchers collected information from a total of 21 studies and 8 abstracts from various conferences which provided overall data regarding at least 40,000 patients totaling 150,000 years cumulatively in order to determine the impact of exposure to TNF inhibitor medications.

Four of the studies involved revealed that patients taking TNF inhibitors were nearly 45% more likely to eventually develop some form of skin cancer aside from melanoma. Two of the studies showed that people using TNF inhibitors were up to 79% more likely to develop melanoma in comparison to those who do not take drugs for Rheumatoid Arthritis.

Currently, the FDA has approved a total of 5 TNF inhibitors to be used in the treatment of Rheumatoid Arthritis as well as psoriatic arthritis and other comparable conditions. These medications include Humira (adalimumab), Cimzia (certolizumab pegol), Enbrel (etanercept), Simponi (golimumab, and Remicade (infliximab). The study under discussion did not include the medications Enbrel and Cimzia due to the fact that they were approved after the research review.

Authors of the study concluded that using TNF inhibitors clearly seems to be linked to an increased risk of skin cancer, including melanoma. Patients currently using TNF inhibitors or thinking of using TNF inhibitors for treating conditions such as Rheumatoid Arthritis should be aware of all risks including a risk for severe infections due to the fact that the medications directly affect the immune system. As of September 7, 2011, the FDA has issued a warning regarding the increased risk of bacterial infections from bacteria called Listeria and Legionella for those taking TNF inhibitors.

References:

Mariette X et al. Annals of the Rheumatic Diseases. 2011; doi: 10.1136/ard.2010.149419.

Mitchell, D. 2011. Rheumatoid Arthritis Drugs May Increase Skin Cancer Risk.


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