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The foodstuff and Drug management is investigating whether a group of big-selling drugs for arthritis and Crohn’s disease heighten the risk of cancer in children and adolescents.The four drugs under scrutiny are biologic treatments known as tumor necrosis factor inhibitors, or TNF blockers, and comprise Johnson & Johnson’s Remicade, Abbott Laboratories’ Humira, Amgen Inc. and Wyeth’s Enbrel, and UCB SA’s Cimzia.The FDA review is the latest in a spate of concern about side effects that have bubbled up in new months. In February, the contributions warned about an increased risk of suicide associated with Pfizer Inc.’s smoking-cessation medication, Chantix, and last month, a nonprofit group issued a report calling attention to other possible side effects allied to the drug. The FDA is also contemplating adding new suicide warnings to the label of epilepsy drugs.

A possible friendship flanked by TNF blockers and some cancers has been recognized for years in adults, as reflected in labeling. Now, the FDA is looking into the potential risk in patients 18 years and younger because of information of cancer in about 30 children and young people who took the drugs over the past 10 years, since the first TNF blocker was approved.The drugs work by suppressing the activity of the TNF protein, which can cause irritation and immune-system disease. But TNF is potentially practical in destroying tumor cells, so blocking its activity in the body could raise one’s risk of cancer.The majority of patients who use TNF blockers are adults, but three of the four drugs are approved for pediatric use in certain disease.

work its review “still very preliminary,” the FDA expects to issue recommendation within six months, according to spokeswoman Rita Chappelle. Possible outcome could include a labeling change, the addition of a so-called black-box caution to the drugs, or letters informing health-care providers of the possible risk, she said.Such moves could have a big financial impact on the companies. J&J’s Remicade, approved to treat Crohn’s disease, a chronic bowel state, in children and 14 conditions in adults, had $3.3 billion in global sales last year. A J&J spokesman said the company is cooperating with the FDA to provide it data.Abbott’s Humira, which brought in $3 billion in income for the suburban-Chicago company last year, received its first pediatric approval in February. Abbott says there haven’t been instances of lymphoma, the form of cancer linked with about half of the 30 cases, in children who have in use Humira either in clinical trials or since its advertising sanction, a company delegate supposed.