| Roman Bystrianyk 2005-04-05, 5:08 pm |
| http://www.healthsentinel.com/news....ist_item&id=718
"Arthritis drug link to infections", BBC News, April 3, 2005,
Link: http://news.bbc.co.uk/2/hi/health/4400843.stm
A common family of drugs used to treat rheumatoid arthritis have been
linked with skin problems.
Up to a quarter of people taking anti-TNF drugs get skin infections,
rashes or eczema, a Dutch study in Arthritis Research and Therapy
reveals.
Experts said the benefits of anti-TNF drugs would outweigh any skin
risks for most patients using this therapy.
However, other arthritis drugs have had safety concerns, potentially
cutting down treatment options for some.
Safety concerns
Last year Merck voluntarily withdrew its blockbuster arthritis drug
Vioxx (rofecoxib) from the market after data showed users had a 50%
higher chance of a heart attack and sudden cardiac death.
European regulators later warned that other drugs in the same family as
Vioxx - the COX-2 inhibitors - might carry a similar risk.
Rheumatoid arthritis patients taking a toxic drug called methotrexate
were also warned about 25 deaths and 26 cases of serious harm linked to
its use in the last 10 years, largely due to the wrong dose being
prescribed.
The current concern stems from a study of 289 patients with rheumatoid
arthritis being treated with anti-TNF drugs for one to 10 years.
These drugs work by switching off tumour necrosis factor (TNF), which
stimulates cells to produce the inflammation response that leads to
pain and swelling of the joints.
Unlike the COX-2 painkillers that merely mask symptoms, anti-TNF drugs
work to tackle the cause of the problem and are called
disease-modifying drugs for this reason.
Rashes
Seventy-two (25%) of the patients developed a skin problem that led
them to visit a skin specialist.
In comparison, only 13% of a similar group of rheumatoid arthritis
patients that had not received anti-TNF had visited a dermatologist
during the same period of time.
The most frequent skin complaints associated with anti-TNF use were
skin infections, eczema and allergic rashes.
For seven of the patients, the skin condition was severe enough that
they stopped the drug.
The investigators from Radboud university Nijmegen Medical Centre said
their findings showed that skin conditions were "a significant and
clinically important problem" in rheumatoid arthritis patients on
anti-TNF drugs.
They said that because of the way anti-TNF drugs work, suppressing the
immune system, they might make users more susceptible to skin
conditions.
They recommended further research.
An adviser to the Arthritis Research Campaign, Madeline Deavy, urged
people using these drugs not to be alarmed by the findings.
"It is a relatively small study. These drugs have been used by hundreds
of thousands of people without major side-effects.
"These are very powerful drugs and any drug will have some
side-effects.
"Most people on anti-TNF therapy have got very serious rheumatoid
arthritis. Minor skin problems might not be a bad pay-off for the
benefit that they do give."
She said many more people with rheumatoid arthritis might benefit from
anti-TNF therapy.
"There is a lot of evidence that if you put people with early
rheumatoid arthritis on these drugs they do much better. There's even
evidence that if you hit the disease very early on some people go into
remission."
The NHS treatment advisory body NICE is currently re-evaluating how
widely prescribed these drugs should be.
Arthritis Care echoed these views and added that doctors were compiling
a register (The Biologics Register) to get a better picture of the
side-effects experienced by patients on anti-TNF treatment.
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