TNF - tumor necrosis factor is the action that
Dr. Edward Tobinick claims is the main problem with recovery from stroke. He uses Etanercept and injects it into the neck in a patented way. This may give your doctor some more information on risks of using this.
http://www.amjmed.com/article/S0002-9343%2814%2900488-4/abstract?rss=yes
Received:
November 18, 2013;
Received in revised form:
May 22, 2014;
Accepted:
June 9, 2014;
Published Online: June 17, 2014
Publication stage:
In Press Accepted Manuscript
Highlights
- •Adalimumab,
certolizumab pegol, and infliximab are associated with a higher risk of
serious infection, which appears to contribute to higher rates of
discontinuation.
- •In contrast, etanercept showed a lower rate of discontinuation with a tendency towards a lower rate of serious infection.
- •These comparative safety findings should inform clinical and policy decision making in the management of rheumatoid arthritis.
Abstract
Objective
To
evaluate and update the safety data from randomized controlled trials
of TNF inhibitors (TNFis) in patients treated for rheumatoid arthritis.
Methods
A
systematic literature search was conducted from 1990 through May 2013.
All studies included were randomized, double blind, controlled trials of
patients with rheumatoid arthritis that evaluated adalimumab,
certolizumab pegol, etanercept, golimumab, or infliximab treatment. The
serious adverse events and discontinuation rates were abstracted, and
risk estimates were calculated by Peto odds ratios (ORs).
Results
Forty-four
randomized controlled trials involving 11,700 subjects receiving TNFis
and 5,901 subjects receiving placebo and/or traditional
disease-modifying anti-rheumatic drugs (DMARDs) were included. TNFi
treatment as a group was associated with a higher risk of serious
infection (OR, 1.42; 95% CI, 1.13-1.78) and treatment discontinuation
due to adverse events (OR, 1.23; 95% CI, 1.06-1.43) compared with
placebo and/or traditional DMARD treatments. Specifically, patients on
adalimumab, certolizumab pegol, and infliximab had an increased risk of
serious infection (OR, 1.69, 1.98, and 1.63) and showed an increased
risk of discontinuation due to adverse events (OR, 1.38, 1.67 and 2.04).
In contrast, patients on etanercept had a decreased risk of
discontinuation due to adverse events (OR, 0.72; 95% CI, 0.55-0.93).
Although ORs for malignancy varied across the different TNFis, none
reached a statistical significance.
Conclusion
These
meta-analysis updates of the comparative safety of TNFis suggest a
higher risk of serious infection associated with adalimumab,
certolizumab pegol, and infliximab, which appears to contribute to
higher rates of discontinuation. In contrast, etanercept use showed a
lower rate of discontinuation. These data may help guide clinical
comparative decision making in the management of rheumatoid arthritis.
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