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TNF biologics linked to multiple sclerosis

New research from Arthritis Research Canada has shown a link between anti-TNFα biologics and multiple sclerosis.

New research from Arthritis Research Canada has shown a link between anti-TNFα biologics and multiple sclerosis. Anti-tumor necrosis factor alpha (TNFα) agents are a class of biologic drugs used for the treatment of several immune-mediated conditions. 

For people living with severe inflammatory diseases such as rheumatic disease (RD) or inflammatory bowel disease (IBD), anti-TNFα medications have been consistently proven to be effective in significantly improving quality of life, as well as preventing joint and tissue damage, disability and premature death.

However, the question that had not yet been clearly answered was whether anti-TNFα medications may be linked to development of multiple sclerosis (a disease affecting the brain and spinal cord). While increased risk of multiple sclerosis (MS) with using these drugs has been suggested, studies have been limited.

Arthritis Research Canada researchers investigated this question by analyzing routinely collected health datasets from four Canadian provinces (i.e., British Columbia, Alberta, Manitoba, and Saskatchewan). Within those datasets the team found that of the 296,918 individuals with rheumatic disease, 462 people developed MS. The team then compared the records of those with MS with 2,296 controls (patients with RD, but not MS) and identified how many of the patients with RD took anti-TNFα medication in the last two years prior to their diagnosis of MS. They found that 18 people with RD and MS took an anti-TNFα, versus 42 of the 2,296 patients who had RD but not MS.

After adjusting for important variables that could influence the risk of developing MS, it was found that people with RD who took an anti-TNFα had a 105% increased risk of developing MS compared to people with RD who didn’t take an anti-TNFα. However, to put this risk into perspective, it is important to note that 2,268 people with RD would need to take an anti-TNFα in order for one person to get MS.

“People with rheumatic disease who have a family history of multiple sclerosis should not be taking these drugs, there are other drug options,” said Arthritis Research Canada, Senior Scientist. Dr. J. Antonio Aviña-Zubieta. “However, because the risk is very rare, for those without a family history of multiple sclerosis, the benefits of anti-TNFα for managing RD outweigh the risks.”

The study concluded that these findings could help clinicians and patients with rheumatic disease to make more informed treatment decisions. Further studies are needed to validate these results for people with inflammatory bowel disease.

Source: Arthritis Research Canada

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