Reported in Unavadis, a large study of Swedish health registry data indicates that lymphoma risk remains elevated among patients with rheumatoid arthritis (RA), despite evolution of treatment. Treatment advances for RA do not appear to have affected lymphoma risk. Records from 12,656 patients with RA from the Swedish Rheumatology Register linked to Swedish Cancer Register were compared with control patients for lymphoma incidence over time.
Comment: Disturbing since I would expect our newer treatments to decrease lymphoma risk.
Tocilizumab Receives Breakthrough Designation for GCA
The FDA granted the designation of breakthrough therapy to tocilizumab (Actemra) for treating GCA (Giant Cell Arteritis). This autoimmune disease causes inflammation of arteries both medium and large in size, predominantly in the head, but also in the aorta and branches of the aorta.1
To date, GCA treatment has been limited to high-dose steroids, which are used as an emergency treatment to prevent vision loss and other damage. Long-term, flare-free remission cannot always be maintained with steroids. Because of the variety of symptoms, GCA patients are usually seen by myriad specialists, including rheumatologists.
The FDA gives a breakthrough designation to expedite the development and review of treatments that show early evidence of potential clinical benefit in serious diseases to ensure patients receive access to medication as quickly as possible. Positive results of tocilizumab use in patients with GCA were seen in the Phase 3 GiACTA study. Patients treated with tocilizumab, initially as combination therapy for six months with glucocorticoids, had sustained remission though one year of treatment compared with patients who received only glucocorticoids for six to 12 months.
Comment: GCA is a serious condition and this is great news.
A treatment for ankylosing spondylitis bites the dust… next
Otezla Fails In Ankylosing Spondylitis Study
Dr. Jack Cush writing in RheumNow reported that ClinicalTrials.gov has listed the results of the POSTURE study, a large randomized placebo-controlled trial wherein apremilast (Otezla) was found to yield no benefit (compared to placebo) in treating ankylosing spondylitis (AS) (32.5% vs. 36.6% ASAS20 at week 16) patients. These findings make it unlikely that Celgene will pursue AS as an indication for apremilast.
Comment: I’m not surprised. Otezla’s effects are modest.
Do the immunosuppressive drugs used in rheumatoid arthritis treatment increase cancer risk? The answer next…
Most immunosuppressive drugs do not significantly increase the risk of breast cancer recurrence
Dr. Lara Pullen writing in Arthritis and Rheumatology reported on a study involving 3 large populations of women with rheumatoid arthritis or inflammatory bowel disease who had undergone surgery for primary breast cancer. What the researchers found was that the risk of breast cancer recurrence in patients who received methotrexate or anti-TNF therapy did not have a significant risk of breast cancer recurrence.
Comment: I think this is reassuring news for clinicians who choose to start methotrexate or anti-TNF therapy in rheumatoid arthritis or inflammatory bowel disease patients with treated breast cancer.
Cell Therapy Uses Genetically Redesigned T-Cells To Fight Some Types Of Cancer
Andrew Pollack writing in the New York Times reported in 4,400-word feature piece as part of its “Cell Wars” series on immunotherapy, on the technique of cell therapy, which extracts T-cells from a patient’s blood, which are “then genetically engineered to recognize and destroy cancer.” The “souped-up” cells are “multiplied in the laboratory, and millions or billions of them are put back into the patient’s bloodstream.” Each killer cell, which are “genetically engineered to produce a complex protein,” can destroy up to 100,000 cancer cells. Cell therapy has only treated a few hundred patients, and for “now it works only for certain types of blood cancers, not common malignancies like breast and lung cancer.” However, the technique has “produced complete remissions in some patients who were out of treatment options,” exciting physicians and patients “and setting off a race among companies to bring the treatments to market.”
Comment: Maybe we can’t get away from using those horrendous chemotherapies we now use.