British researchers report in the July 17 issue of The New England Journal of Medicine about the case of a 69 year old female ex-smoker who was being treated for Crohn’s disease with anti-TNF medications. During this time she developed lung cancer. After stopping the medication, the researchers discovered that the cancer disappeared.

A theory being considered is that the woman, who had been a heavy smoker for 35 years, had an immune system that kept the cancer in check. But the anti-TNF treatments may have weakened her immune system which allowed the cancer to develop.

According to co-author Jack Satsangi, professor of gastroenterology at the University of Edinburgh in Scotland, the woman’s lung cancer “was expected to be fatal within months.” After stopping the anti-TNF treatments “the cancer has completely regressed – and she is health more than two years after.”

“This is most remarkable, and adds to the concerns regarding the use of these agents, and we do not use these drugs in patients with heavy smoking histories,” Satsangi said.

Researchers have seen an association between TNF medications and lung cancer, particularly in ex-smokers. There are also concerns about these drugs and the development of other cancers, such as lymphoma.

“There is an underlying concern about the use of these drugs and the possible increase of certain kinds of cancer,” said Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society. “This report raises the awareness that doctors and patients have to have in using these drugs. We certainly need to be more vigilant about lung cancer in patients who get these treatments.”

Originally posted 2008-07-17 23:01:45. Republished by Blog Post Promoter

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The FDA has received 30 reports of cancer in children under the age of 18 who had been treated for JIA with anti-TNF drugs along with other medications, such as methotrexate, or similar immunosuppressant drugs.

Nearly 50% of the reports state the patients developed Hodgkin’s and non-Hodgkin’s lymphoma. The other reports indicate development of melanoma, leukemia and solid organ cancers.

Besides rheumatoid arthritis, TNF blockers are used to treat psoriatic arthritis, Crohn’s disease, plaque psoriasis, ankylosing spondylitis, as well as other diseases. TNF blockers are know to result in inflammation and weakening of the immune system.

The manufacturers of these drugs have been directed by the FDA to provide information about all TNF blocker recipients who have developed cancer, and in some cases to track cancer reports for 10 years. The FDA has also requested the assistance of medical professionals and patients in reporting any side effects from TNF blockers through the MedWatch Adverse Event Reporting program at www.fda.gov/medwatch/report.htm.

Originally posted 2008-06-06 22:25:05. Republished by Blog Post Promoter

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The packaging already is required to warn about fungal infections in general, but the new warnings will have to specifically call out histoplasmosis. This is a result of the FDA receiving reports of 240 patients who were taking TNF blockers that developed histoplasmosis. Of those 240, 45 patients died, including at least 12 who had not been immediately been diagnosed with histoplasmosis leading to a delay in treatment. The ages of these patients ranged from 8 to 86 years, however, none of the deaths involved children.

Histoplasmosis starts in the lungs and can spread to other organs in the body. If not treated in time, it can lead to death. In healthy people the body’s immune system is able to control the histoplasmosis infection. The risk is to people that have compromised immune systems, such as patients with AIDS or taking immune system suppressing drugs, such as alpha blockers.

The fungus that causes histoplasmosis, histoplasma capsulatum, is found throughout the world. It grows in the ground and in material that is contaminated with bat or bird droppings. Concentrations can be especially high in bird roosts, caves where bats roost and poultry house litter. Histoplasmosis is also more common in the Mississippi and Ohio River Valleys.

Symptoms of histoplasmosis include shortness of breath, fatigue, cough and fever.

Anti-TNF drugs are used to treat rheumatoid arthritis, psoriatic arthritis, plaque psoriasis, juvenile idiopathic arthritis, ankylosing spondylitis and Crohn’s disease.

The FDA published their directive on September 4th. You can read the actual release here

Originally posted 2008-09-06 18:46:48. Republished by Blog Post Promoter

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Recently a team of Spanish researchers, led by Dr Alberto Alonso-Ruiz has reviewed the findings of 13 clinical trials involving over 7,000 participants to compare anti-TNF to DMARDS. The team analyzed the data to determine the benefits and side effects of different doses of the drugs.

The team determined that all of the trials showed that, with the proper dose, anti-TNF were better for treating rheumatoid arthritis than drugs like methotrexate.

The research also pointed out, however, that those patients using anti-TNF drugs were more likely to complain of adverse side effects. In addition, patients that were using etanercept experienced the lowest withdrawal rates due to adverse events.

“Performing comparisons of new drugs is vital for measuring safety/efficacy relationships and monitoring adverse side-effects” said Dr. Alonzo-Ruiz.

Their research was published in the journal BMC Musculoskeletal Disorders.

Originally posted 2008-05-02 15:36:39. Republished by Blog Post Promoter

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