Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Is there an association between anti-TNF monoclonal antibody therapy in rheumatoid arthritis and risk of malignancy and serious infection?. | Available online http content 8 5 111 Commentary Is there an association between anti-TNF monoclonal antibody therapy in rheumatoid arthritis and risk of malignancy and serious infection Commentary on the meta-analysis by Bongartz et al. Will Dixon and Alan Silman Epidemiology Unit University of Manchester Medical School Manchester UK Corresponding author Will Dixon Published 11 August 2006 This article is online at http content 8 5 111 2006 BioMed Central Ltd Arthritis Research Therapy 2006 8 111 doi ar2026 Abstract A recent meta-analysis of randomized clinical trials reported by Bongartz and coworkers raised concerns about an increased rate of malignancy and serious infection in rheumatoid arthritis patients treated with anti-tumour necrosis factor monoclonal antibodies. This commentary discusses some of the methodological issues in their analysis and urges caution in interpreting the results. Introduction The introduction of anti-tumour necrosis factor TNF agents and their widespread use particularly for treating rheumatoid arthritis RA is based on favourable results from large-scale randomized clinical trials RCTs . The trial data were rightly also utilized to investigate possible hazards associated with the use of these drugs and the results have mostly been reassuring. The problem is that all of these trials are individually too small and of insufficient duration to provide useful data on rare but serious long-term hazards. In addition RCTs are typically conducted in lower risk patients . those patients with significant current or recent co-morbidity are excluded . One approach to overcome the small size of individual studies is to undertake a pooled or meta-analysis of all relevant trials. Although this is indeed a frequently used approach to derive robust estimates of efficacy the data gathered in trials on potential long-term hazards are not routinely subjected to similar
