University of Alabama Birmingham (UAB) pharmicoepidemiologist Tim Beukelman and his team of researchers combed through millions of records of children to determine if a life-altering drug for juvenile arthritis, called a TNF-Blocker, could cause cancer. The drugs are considered highly effective for the treatment of inflammation attacks on children’s joints as a result of juvenile arthritis, a condition that can be disabling. However, the medication also carries a black box warning that some lymphomas and other malignancies, some of which were fatal, had been reported in children using the drug.
Reports of cancer were enough to result in the boxed warning, but there were holes in the data. For one, the actual rate of cancers in children with juvenile arthritis who did not take TNF-Blockers was unknown. If the rate in these children was higher than in other children, then it could suggest that the drug wasn’t the cause of the cancers. Determining this, however, would take thorough research.
Beukelman and his team set out to answer this question by poring through the medical records of some 30 million children from 2000 to 2005. They found 7,812 children with juvenile arthritis, 1,484 of whom were treated with a TNF-Blocker. The team also compared groups of 974,055 children who had other chronic diseases including asthma and attention deficit-hyperactivity disorder, and looked for evidence of cancer.
What the researchers determined is that while the risk is still very low, having juvenile arthritis alone increased the child’s risk for cancer, compared to healthy children. Overall, the data suggests that treatment with TNF-Blockers does not appear to increase the risk of cancer in children with juvenile arthritis. Beukelman is following up his study with four more years of Medicaid billing records. The study was published this week in the journal Arthritis & Rheumatism.
TNF-Blockers were approved in 1998 as a treatment for children with juvenile idiopathic arthritis (JIA), rheumatoid arthritis, psoriatic arthritis, plaque psoriasis, inflammatory bowel disorder, and Chron’s disease.