Tumor necrosis factor (TNF) inhibitors are a class of medication that can successfully treat children with juvenile idiopathic arthritis (JIA). But in 2009, many turned away from the drugs after a U.S. Food and Drug Administration (FDA) warning linked them to increased cancer risk. Now, research shows TNF inhibitors do not pose that danger and may safely help manage JIA.
TNF inhibitors are prescribed for several inflammatory conditions, most notably JIA, rheumatoid arthritis, and ankylosing spondylitis. The drugs suppress the immune system by interfering with a protein that causes inflammation and immune system disorders. Well-known TNF inhibitors include etanercept (Enbrel), adalimumab (Humira), and infliximab (Remicade).
New Research Shows TNF Inhibitors Don’t Pose Cancer Risk
During a 2016 meeting of the American College of Rheumatology, Timothy G. Beukelman, MD, presented findings of a large database review that found the cancer risk for JIA patients taking TNF inhibitors was similar to those children who did not take TNF inhibitors. The review used records from health insurance claims from 2000 to 2014.
The findings contradict a 2009 FDA announcement that TNF inhibitors may increase the risk of some cancers, such as lymphoma, in children and young adults. The announcement came after a 2008 FDA investigation on the potential connection between TNF inhibitors and cancer in children. The FDA reviewed approximately 30 reports involving children and young adults who had been taking TNF inhibitors and then developed cancer.
Dr. Beukelman and his colleagues believe the FDA warning did not acknowledge the impact other common JIA drugs had on cancer risk or that JIA alone increases cancer risk.
The research team said TNF inhibitors can provide significant benefits for children with JIA and may be taken safely. But, like all medications, they do have risks. TNF inhibitors carry labels alerting patients to potential adverse effects, including increased risk of developing an infection or cancer. They also carry a "black box" label that warns doctors and patients about the potential cancer risk, specifically in children, which appeared in response to the FDA’s 2009 warning. Despite these new research findings, the black box label will remain.
Weigh the Risks and Benefits with Your Doctor
While TNF inhibitors can help manage inflammatory disorders, always discuss any concerns you have about your drugs and medications with your doctor. He or she will help weigh the risks and benefits and determine the best treatment option for you. You can read more about TNF inhibitors and other common treatments for JIA in Juvenile Idiopathic Arthritis Treatment.