Immune checkpoint inhibitors (ICIs) are at the forefront of advances in cancer therapy and have shown promising results for progression-free survival. Checkpoint signaling pathways, such as cytotoxic T-lymphocyte antigen 4 (CTLA-4) and programmed cell death protein 1 (PD-1), normally regulate the immune response to promote self-tolerance and prevent tissue damage and inflammation. PD-1 is a…
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TNF Inhibitors Do Not Seem to Boost Cancer-Recurrence Rates
NEW YORK (Reuters Health)—Tumor necrosis factor (TNF) inhibitors do not appear to increase cancer-recurrence rates in patients with rheumatoid arthritis (RA), according to new findings from Sweden. TNF has both tumor-promoting and cancer-protective effects, so TNF inhibitors could conceivably affect the risk for cancer recurrence. However, few studies have reported the risk for cancer relapse…
Prenatal TNF Inhibitor Exposure Not Linked to Serious Infections
NEW YORK (Reuters Health)—Children of women with rheumatoid arthritis (RA) who are exposed to tumor necrosis factor-alpha inhibitors (TNFis) in the womb are not at markedly increased risk of serious infections, new findings suggest. “It’s reassuring for mothers who need to take these medications during pregnancy,” Evelyne Vinet, MD, of McGill University Health Center in…
Study Assesses Immune Checkpoint Inhibitors Safety in Rheumatic Disease
Since they were first introduced in 2011, immune checkpoint inhibitors (ICIs) have become an important treatment for an expanding list of advanced cancers. Some concerns have been raised around the mechanism of action of these immunotherapy agents, making their use in rheumatic diseases (RD) problematical. An article in the March 2018 issue of Arthritis &…
TNF Inhibitors May Not Be Linked to Cancer Risk in Kids
NEW YORK (Reuters Health)—Using tumor necrosis factor (TNF) inhibitors in children is not significantly associated with cancer risk, according to a new study. “TNF inhibitors are remarkably effective for the treatment of many autoimmune conditions, but physicians worry that they cause cancer,” Dr. Timothy Beukelman from the University of Alabama in Birmingham told Reuters Health…
TNF Inhibitor Drug Tapering Successful in Some Patients with RA
MADRID—Scores on the Health Assessment Questionnaire for Rheumatoid Arthritis (HAQ) and C-reactive protein (CRP) levels were independent predictors of whether patients could be tapered successfully from a TNF inhibitor after having reached remission of their RA, according to findings presented in a session at the Annual European Congress of Rheumatology. Researchers also developed a composite…
Disease-Activity-Guided TNF Inhibitor Dose Reduction Works Long-Term in RA
NEW YORK (Reuters Health)—In patients with rheumatoid arthritis (RA), disease-activity-guided dose reduction of a tumor necrosis factor inhibitor (TNFi) is safe and effective in the long-term and leads to a large reduction in TNFi use, according to three-year data from the DRESS study. Implementation of this strategy would “vastly improve the cost-effective use of TNFi,” conclude Dr….
Ixekizumab Eases Psoriatic Arthritis when TNF Inhibitor Fails
NEW YORK (Reuters Health)—The selective interleukin-17A inhibitor ixekizumab improved signs and symptoms of active psoriatic arthritis (PsA) in patients who had failed prior biologic therapy in the phase 3 SPIRIT-P2 trial. The SPIRIT-P2 trial joins the earlier phase 3 SPIRIT-P1 trial, which showed that ixekizumab was safe and effective in PsA patients not previously treated…
The Immune Checkpoint Inhibitors Unleashed to Fight Cancer
A 53-year-old female presented to the clinic for severe polyarticular joint pain and was found to have a seronegative inflammatory arthritis. Six months before, she had completed 10 months of treatment for stage IV metastatic melanoma with the immune checkpoint inhibitors, nivolumab and ipilimumab, achieving complete remission of her cancer. She said that throughout her…
Immune-Related Adverse Events with Use of Checkpoint Inhibitors for Immunotherapy of Cancer
Introduction: Major advances in the past two decades have enhanced our understanding of the complex interactions between the immune system and cancer cells and their environment. Genetic and epigenetic alterations in tumor cells result in the expression of diverse antigens that can elicit an immune response, primarily mediated by T cells. Immune responses are regulated…
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