Article information
Abstract
Tumor necrosis factor (TNF) is implicated in the control of tumoral growth in addition to the systemic inflammatory response. TNF blockage produces a comprensible reservation in patients with risk factors for cancer. No clear evidence for this came out from pre-clinical or clinical trials. Biosafety registries established in the post-marketing phase have concluded that, in general, cancer cases have not increased over what is expected in a population with RA exposed to the prolongued use of anti-TNF drugs. A meta-analysis of clinical trials which used infliximab and adalimumab for RA treatment showed an increase of up to three times the risk of developing cancer, but this dissapeared after correcting for time. Biobadaser shows evidence that support long-term safety. In the long-term, and if the inflammatory disease activity is truly under control, the risk of developing cancer is the same as with any other patient.
Keywords:
Infliximab
Etanercept
Adalimumab
Cancer
Adverse event
Resumen
El factor de necrosis tumoral (TNF) está implicado en el control del crecimiento de tumores además de en la respuesta inflamatoria sistémica. El bloqueo del TNF produce un recelo comprensible en pacientes con riesgo de cáncer. Ni en el desarrollo preclínico ni durante los ensayos clínicos de los anti-TNF se detectaron alarmas claras. Los registros de seguridad de biológicos establecidos en el período poscomercialización han concluido que el cáncer en general no está aumentado con respecto de lo esperado en una población de AR con el uso prolongado de anti-TNF. Un meta-análisis de ensayos clínicos de infliximab y adalimumab mostró un aumento de hasta tres veces el riesgo de cáncer, pero al corregir la exposición por el tiempo en los mismos no se encontró. En BIOBADASER tenemos evidencias que apoyan la seguridad a largo plazo. A largo plazo, y si realmente la actividad inflamatoria de la enfermedad subyacente está controlada, el riesgo de desarrollar un cáncer es igual que el de cualquier paciente.
Palabras clave:
Infliximab
Etanercept
Adalimumab
Cáncer
Efecto adverso
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