TNF Inhibitors Do Not Increase Risk of Tumor Malignancy in Pediatric IBD, Study Shows

TNF Inhibitors Do Not Increase Risk of Tumor Malignancy in Pediatric IBD, Study Shows
Treatment of pediatric inflammatory bowel disease (pIBD) with tumor necrosis factor inhibitors (TNFi) does not increase the risk for malignancy, researchers report. The study with that finding, “Risk of malignancy associated with paediatric use of tumour necrosis factor inhibitors,” was published in the journal Annals of the Rheumatic Disease. TNF is a pro-inflammatory cytokine, which is a type of molecule released by immune cells. Treatment with TNFi inhibitors is effective in pIBD, as well as in juvenile idiopathic arthritis (JIA) and pediatric plaque psoriasis (pPsO). Despite the clinical benefit, concerns over the potential increase in the rate of malignant tumors in children due to TNFi use are well-known. These concerns first appeared in a 2009 report from the U.S. Food and Drug Administration, which demonstrated an increased risk of lymphoma with using Remicade (infliximab, by Janssen). However, that initial study did not account for the effect of the underlying disease in malignancy risk, or the risk associated with other immunosuppressive medications, the researchers noted. Evidence shows that the use of the immunosuppressive IBD medication thiopurine, which often is prescribed prior to TNFi, is linked with malignancy, particularly lymphoma, in adult IBD patients. The very low incidence of pediatric malignancy and the limited number of children treated with TNFi have hampered definitive conclusions about their potential
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