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November 8, 2006

Risk of Serious Infections and Malignancies With Anti-TNF Antibody Therapy in Rheumatoid Arthritis

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2006;296(18):2201-2204. doi:10.1001/jama.296.18.2202

To the Editor: We have a number of concerns about the meta-analysis of anti-TNF antibody therapies in RA and the risk of serious infections and malignancies by Dr Bongartz and colleagues.1 First, the pharmacological justification for excluding etanercept from the meta-analysis was not germane to actual clinical experience with anti-TNF agents. To further substantiate the results of the meta-analysis, the authors also cited a study in which patients receiving etanercept showed an increased number of solid malignancies.2 Etanercept is widely prescribed for patients with RA, and we believe that data for etanercept should have been included in the meta-analysis.