"In the [anti-TNF] clinical trials, most of which were less than a year [in duration] there was not an increase in cancer except for [nonmelanoma skin cancer]," Dr. Symmons observed. "The cancer risk in observational studies is not increased in the short term," she added, "but we still don’t know what the long-term risk might be."
Echoing her comments were the separate findings of a Wyeth-sponsored study presented as a poster at the meeting. Dr. Peter Taylor of the Kennedy Institute of Rheumatology in London and his associates looked at the risk of malignancy associated with TNF inhibitors in registries and prospective observational studies. They reported a pooled-risk estimate of 1.11 for lymphoma, 1.45 for nonmelanoma skin cancer, and 1.79 for melanoma comparing TNF-treated patients with nonexposed RA patients.
Dr. Taylor and his team said of their findings: "This systematic review and meta-analysis provide reassurance to physicians and patients that treatment of RA patients with TNF inhibitors does not increase the risk of malignancy in general, or of lymphoma in particular, but does appear to increase the risk of skin cancer, including melanoma."
The systemic review and meta-analysis was sponsored by Wyeth. Dr. Taylor has received research grants and honoraria from Abbott, Bristol-Myers Squibb, Pfizer, Roche, Schering-Plough, and UCB. The BSRBR is funded by a grant from the British Society for Rheumatology. The BSR receives funding from Abbott Laboratories, Biovitrum/SOBI, Merck Sharp & Dohme Ltd., Pfizer, Roche, and UCB. This income finances a separate contract between the BSR and the University of Manchester that provides and run the BSRBR. All decisions concerning data analysis, interpretation and publications are made autonomously of any industrial contribution.
Dr. Mercer, Dr. Symmons, and Dr. Matteson declared that they had no personal conflicts of interest.