FDA Links TNF Blockers to Blood Cancer

Health regulators in the United States have been receiving increasing reports of what are normally quite rare blood cancers being found in younger patients (adolescents and young adults) who are taking drugs in a category of anti-inflammatory medications typically used to treat disorders of the digestive system. These drugs, which are known as tumor necrosis factor blockers or TNF blockers, are most often used to treat symptoms of Crohn’s disease and of ulcerative colitis, which cause the digestive system to become inflamed. The drugs taken by the patients include a number of widely-used medications, such as Merck & Co Inc and Johnson and Johnson’s Remicade and Simponi, as well as Enbrel (created by Amgen Inc) and Humira (created by Abbott Laboratories). Another drug studied was UCB SA’s Cimzia.

Blood Cancer

The Food and Drug Administration has, in the past, warned the medical community of an increased risk for lymphoma and other types of cancer being connected to the use of TNF blockers, especially in younger children and adolescents. The FDA reported on April 14 that a generally quite rare type of blood cancer, Hepatosplenic T-Cell Lymphoma, also called HSTL, is increasingly being reported in adolescents and young adults who take TNF blockers. The risk is further increased in patients that are taking other drugs, such as azathioprine, which suppress the immune system. Also adding to the risk is mercaptopurine, a drug used in leukemia treatments.

The product labels for the TNF blockers as well as the drugs that contribute to HSTL risk have been updated to include warnings about their interaction, as well as the increased risk of HSTL. In most of the reports in which blood cancers were developed by young patients, said patients were being treated for Crohn’s disease or ulcerative colitis, although the reports also included patients being treated for psoriasis and rheumatoid arthritis. The study found that TNF blockers aid in suppressing the immune system by helping prevent activity of the tumor necrosis factor, which is a substance in the body that causes inflammation and leads to diseases of the immune system.

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