Dr. Timothy Beukelman, a pediatric rheumatologist, has been looking at the safety of a group of drugs that are successfully used to treat children withjuvenile idiopathic arthritis(JIA). One of his current research projects, called “Tumor Necrosis Factor (TNF) Inhibitors and the Risk of Malignancy in the Treatment of JIA”, was presented at the 2016 ACR conference in Washington, DC.
In 2009, the FDA issued a warning about TNF inhibitors. It stated there could be an increased risk of cancer in children and teenagers who use these drugs to treat JIA and other inflammatory diseases.
Dr. Beukelman said that the FDA analyses did not take into account the chance for increased risk from other drugs used to treat JIA or an increased risk from the disease itself. “The TNF inhibitors have made a tremendous difference for children with arthritis,” Dr. Beukelman said. “Because of these drugs, children who would have been previously confined to wheelchairs can now play in sports with their friends who do not have arthritis. The benefits of these drugs are obvious to patients who take them. I wanted to study the risks to make sure the drugs are safe.”
Dr. Beukelman is the Scientific Director of the Childhood Arthritis and Rheumatology Research Alliance (CARRA), an Arthritis Foundation-funded partner. The partnership (and this study) strive to answer the questions we hear most frequently (like are these drugs safe? what makes one drug work better than another?).
本研究使用2000 - 2014年的医疗保险索赔账单记录。Beukelman博士解释说:“虽然他们提供的信息有限，但账单记录让我们可以研究大量的儿童，而不必单独收集数据。”“例如，CARRA注册中心自2015年启动以来，已经成功登记了2000多名JIA儿童。但在目前的研究中，账单记录允许我们包括超过2.7万名JIA儿童。”
他接着说，“账单记录给我们提供了病人接受的医生诊断信息，比如JIA或癌症。它们还告诉我们患者接受了什么药物，如肿瘤坏死因子抑制剂或癌症药物。仔细分析后，这些数据给我们提供了非常准确的信息，告诉我们患者在治疗关节炎时服用了什么药物，以及他们后来是否患了癌症。”
What the study found was the cancer risk for JIA patients taking TNF inhibitors was similar to the risk for JIA patients who did not take TNF inhibitors.
Through his work, Dr. Beukelman hopes to reduce health provider, parent, and patient concerns about increased cancer risks due to using TNF inhibitors. This is important because TNF inhibitors can greatly improve the lives of JIA patients. However, because of the rarity of childhood cancer in the general population, he feels this study does not provide the final answer. He said that we need to continue to look at the potential long-term TNF inhibitor use.
Dr. Beukelman is an Associate Professor of Pediatrics in the Division of Rheumatology at the University of Alabama at Birmingham.