Is it the disease it's self increasing the risk and not TNF Inhibitors
In the United States around 300,000 children have some form of arthritis, one in one thousand children have Juvenile Idiopathic Arthritis (JIA), the most common form of arthritis in children.
Children with JIA have symptoms similar to adults with arthritis that includes joint pain, stiffness and tenderness and now a new study from the University of Alabama, Birmingham, may be at a higher risk for the development of cancer in comparison to children who do not have the disease. The new study also directs some uncertainty on TNF inhibitors used as a treatment since they were introduced 15 years ago. However, they have been linked to possible cancer risk which resulted in the FDA placing a “black box” waring of the potential malignancy risk.
Researchers using information from the U.S. Medicaid from 2000 to 2005, identified 7,812 children with JIA and compared them with thousands of children without JIA. Researchers had discovered that the children with JIA had developed around four times as many new growths considered likely to be cancerous in comparison to children without the disease. The children had been observed for around 18 months.
Dr. Timothy Beuklman, M.D., associate professor of pediatrics with the university, rheumatology at Children's Hospital in Birmingham and study's lead author, stated that based on the information it appears that being diagnosed with JIA increases the likelihood of developing malignancies. “Since the introduction of TNF inhibitors in clinical practice, there has been concern about an increased risk of malignancy associated with them.”
However, despite the statistically higher cancer in children is rare according to Dr. Sampath Pnahalad, M.D., Acting Associate Professor Rheumatology, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia. Dr. Pnahalad, notes it is more common for children with JIA not to get cancer. Dr. Pnahalad was not part of the study.
Dr. Beuklman states there are a number of possible reasons for the finding but so far no one knows for sure why JIA may predispose children to cancer. Dr. Beuklman does stress that there is no link between cancer risk and any treatments for the condition including TNF Inhibitors which are sold under the brand names Enbrel and Humira, these treatments can at times stop arthritis in its tracks. "The initial concern about TNF inhibitors may have been overstated, since some of the risk likely comes from the disease itself.”
According to Dr. Beuklman, “At least part of the increased risk, and perhaps even all of it, appears to be attributable to the disease itself, or to other medications used in treatment such as methotrexate.” Noting the fact how the disease activity and inflammation in JIA influences the risk is unknown. He calls attention to the fact the research team did not have access to that type of clinical information in this kind of administrative data base.
Other explanations include diseases such as JIA attack the body's own immune system and the body cannot prepare a defense against invading cells. It also can be that the persistent inflammation could lead to cancers especially in blood cells.
Dr. Pnahalad remarked the study is both concerning and comforting. "It's reassuring that these drugs don't seem to increase cancer risk. Clinically, these drugs really make kids better.” He also states that the study tells us we need to be careful in monitoring children long-term to see if other studies confirm this so we can treat it early if something happens.
The study is published in Arthritis & Rheumatism.
There are several main subtypes of JIA which involve chronic joint inflammation. The exact cause of JIA remains unknown. Researchers are studying several factors that may be involved alone or in combination in triggering the inflammation reaction seen in JIA. These factors include genetics, infection and environmental factors.
Conventional treatments for this disease disease include TNF inhibitors, corticosteroids, and DMARDs.
Alternative treatments are increasing for the area of arthritis. Therapies include:
Chiropractic care is on the rise for children with more parents taking their children on a regular basis. Treatments by a chiropractor has been shown to be effective in the treatment of arthritis. Corrections to the joint and spine results in greater range of motion. Adjustments done directly to the joints decreases the pain levels. Chiropractic has also been demonstrated to boost the body's immune system.
Reflexology is beneficial when it comes to children. By stimulating the nerves in the hands and feet results in decreased pain, stiffness and increases mobility. Research has found it to be an effective tool for improving circulation, pain relief and stimulates the immune system. It is a safe and effective treatment.
In Detroit and surround areas:
18700 Woodward Avenue
Detroit
313-366-2247
A & L Chiropractic Center (reflexology offered)
24281 Middlebelt Road
Farmington Hills
248-477-3977
1234 Porter Street
Detroit
313-355-0629
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