by Chris Miller | Posted on 10/16/2012
A study published in Arthritis Care & Research titled, "Risk of malignancy in children with juvenile idiopathic arthritis not treated with biologic agents" has found that children with Juvenile Idiopathic Arthritis (JIA) are almost three times more likely to develop cancer.
Juvenile Idiopathic Arthritis is a term widely accepted by pediatric rheumatologists to "to describe various types of chronic arthritis in children," according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Spondyloarthritis - including Juvenile Ankylosing Spondylitis (JAS) – is included in the subtypes of JIA.
On August 4, 2009, the FDA required that stronger warnings in the prescribing information of the TNF-a inhibitor class of medications, which are used to treat ankylosing spondylitis and related diseases. These warnings had to "highlight the increased risk of cancer in children and adolescents who receive these drugs to treat juvenile rheumatoid arthritis, the inflammatory bowel disorder [known as] Crohn's disease, and other inflammatory diseases." The medications included Remicade (infliximab), Enbrel (etancercept), Humira (adalimumab), Cimzia (certolizumab pegol) and Simponi (golimumab).
However, this recent study suggest that there is an "an elevated underlying risk of cancer in this disease population," since the juveniles in the study had never been treated with biologic therapies. Thus the TNF-a inhibitor medications could not be the culprit in causing the increase of malignancies in the cases seen in the study.
On the subject of cancer risk and the use of biologics, an article on MedPage Today quoted the study authors as stating, "We propose that the interpretation of the risk of cancer in JIA patients treated with biologic agents should be made with consideration for the potential increased risk associated with JIA and conventional treatment."
We'd like to thank Robert A. Colbert, MD, PhD Chief,
Pediatric Translational Research Branch
NIAMS/NIH/DHHS for reviewing the section on JIA and JAS classification within this article.
References & Further Reading:
About the writer: Chris Miller is the Director of Programs at the Spondylitis Association of America and is Managing Editor of SAA's news magazine, Spondylitis Plus. He has been at SAA for nine years.
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