People typically associate chemotherapy with cancer treatment. However, doctors often use chemotherapy drugs (e.x., methotrexate) to treat individuals with autoimmune conditions such as rheumatoid arthritis (RA). Doctors typically prescribe these drugs at much lower dosages for people with RA than they would for those with cancer. This is because the goal of treatment is not to kill cancer cells but to change the behavior of the overactive immune cells. The lower dosage also helps to reduce the severity of potential side effects of ?. Early treatment with chemotherapy drugs can help slow the progression of RA and reduce or prevent joint damage and other serious complications. (3)
Many patients with rheumatoid arthritis have stayed on this drug for 20 years or more. It used to be recommended that every patient who reached a certain lifetime dose of methotrexate receive a liver biopsy, but that is no longer recommended by rheumatology organizations as long as blood tests related to liver function remain normal. Some dermatology organizations remain concerned about liver damage in this setting, particularly in patients with psoriasis. (3)
Carcinogenicity of biopharmaceuticals
While new pharmaceuticals are constantly being developed to alleviate disease in humans, it is recognized that these pharmaceuticals can also be associated with adverse effects due to their chemical structure and/or inherent pharmacologic activity. Therefore, non-clinical and clinical evaluation of human pharmaceuticals is required to demonstrate both effi cacy and safety in the intended clinical therapeutic situation. Carcinogenicity is one of the major safety concerns that is largely de- risked in the non-clinical studies. In this chapter, we focus on the carcinogenic risk of proteins produced by recombinant biotechnology, generally called biopharmaceuticals, as specifi c aspects make them different from conventional small molecules.
Chapter 8 Carcinogenicity of Biopharmaceuticals
Maggie Dempster, et al.,
The anti-TNF hidden problem
2008 FDA black box warning: a possible increased risk of lymphoma and other malignancies in children treated with anti-TNF agents. – 9 cases in registries (mainly lymphomas) – FDA Post-marketing 48 pediatric malignancies (20 in JIA, 28 in IBD), after a median of 2.5 years (range 1 month-7 years), 50% lymphomas, most while using other drugs (steroids, azathioprine, MTX, mercaptopurine) (1)
20th April 1902: Marie and Pierre Curie prove the existence of radium by isolating radium chloride. HistoryPod. https://www.youtube.com/watch?v=UgHmGxXO4Wg
Uranium Reserves: https://en.wikipedia.org/wiki/File:Uranium_Reserves.png.
Global, regional and national burden of rheumatoid arthritis 1990–2017: a systematic analysis of the Global Burden of Disease study 2017
Global, regional and national burden of rheumatoid arthritis 1990–2017: a systematic analysis of the Global Burden of Disease study 2017. https://ard.bmj.com/content/78/11/1463
Conclusions RA is a major global public health challenge. The age-standardised prevalence and incidence rates are increasing, especially in countries such as Canada, Paraguay and Guatemala. Early identification and treatment of RA is vital especially among females, in order to reduce the ongoing burden of this condition. The quality of health data needs to be improved for better monitoring of disease burden.Rheumatoid arthritis is a major global public health challenge. Its age-standardised prevalence rate ranges from 91 to 471 cases per 100 000 population.
Sat0576 The Prevalence Of Rheumatoid Arthritis: A Systematic Review Of Population-Based Studies.
Conclusion: The average point- and period-prevalence of RA were 51/10,000 and 56/10,000 respectively. The RA prevalence was higher in urban areas than rural areas, suggesting an impact of environmental differences. Population database studies were more consistent than sampling studies, and linked databases appeared to provide the best estimate of RA period-prevalence when rheumatologists clinically verified RA. (1)
Rheumatoid arthritis world map - DALY - WHO2004.
Global, regional and national burden of rheumatoid arthritis 1990–2017: a systematic analysis of the Global Burden of Disease study 2017. Saeid Safiri, et al,
Dr. Zach Bush, a triple-board certified endocrinologist gave a lecture connecting soil health, and the widespread use of pesticides in the US, to the rising rates of chronic disease. https://www.youtube.com/watch?v=HL6OPzQe9Is