Case-by-Case Consideration of Risk vs Anticipated Benefit of Anti-TNF Therapy

Patients with inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis are often treated with biologics to induce and maintain remission. But treatment with antibodies against tumor necrosis factor (anti-TNF) have been contraindicated for patients with IBD and prior history of cancer, due to concern over increased risk for new or recurrent cancers. However, new research reported in Inflammatory Bowel Diseases suggests that anti-TNF therapy may be safe for IBD patients with prior cancer histories, whose conditions have not been controlled with other treatments. With advances in treatment during the past 20 years, clinicians are encountering more patients with IBD and with previous or present cancers.

The study is billed as one of the first to evaluate cancer risk from anti-TNF therapy in IBD patients with prior cancer history. In their assessment of 79 patients over a 21-month median follow-up period, the study recorded an overall incidence of recurrent or new cancer of 85 per 1000 patient-years, a result termed a mild risk of incident cancer. The research team suggests that the decision to employ anti-TNF therapy in this patient cohort should be based on a case-by-case balanced consideration of potential increased risk for future cancer vs the need to get the patient’s IBD under control.

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A news story about the findings, with link to the journal article, may be read here.

 

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