TNF Inhibitors May Increase The Risk Of Developing Skin Cancer
Tumor necrosis factor inhibitors, like Etanercept (Enbrel) and Infliximab (Remicade), which are used in the treatment of rheumatoid arthritis, are increasing the risk for developing skin cancer, said a team of researchers.
A new study showed that the risk for developing skin cancer is about one third higher in patients with rheumatoid arthritis who are treated with tumor necrosis factor alpha (TNF) inhibitors than for patients with rheumatoid arthritis who are treated with disease-modifying antirheumatic drugs (DMARDs), like methotrexate or leflunomide.
The study was made on 20.648 patients diagnosed with rheumatoid arthritis. Some of this patients were treated with TNF-inhibitors and some of them with DMARDs. The incidence of skin cancer was 18.9/100 patients,in patients treated with TNF inhibitors and 12.7/100 patient, in patients treated with DMARDs. The risk for developing skin cancer was greater in male patients who were older and had used in the past nonsteroidal anti-inflammatory drugs or glucocorticoids, or had others malignancies.
The researchers concluded that patients with rheumatoid arthritis who are treated with TNF-alpha inhibitors, may have a higher risk to develop skin cancer. This result should lead the rheumatology specialists to follow up the patients with rheumatoid arthritis who are treated with TNF inhibitors, for skin cancer and precancerous lesions, by sending them to a dermatologist for a complete skin exam, at least once a year.
This is an observational study and therefore may be over interpreted. Many studies, to date, on this subject showed that the risk of developing skin cancer is similar to the risk found in the general population. Although this new study shows a relationship between consumption of TNF inhibitors and skin cancer development, but the researchers dose not know if between this two entities exist a causal relationship. In the future, researchers hope to bring more information on this issue and if is necessary to introduce screening programs to prevent skin cancer in rheumatoid arthritis patients who are treated with TNF inhibitors.