[atombender]

> can promote infection/cancer

Note that while TNF inhibitors like adalimumab (Humira) have a black box cancer warning in the US, this was based on assessing a small number of studies early on. We now have more than 20 years of studies and patient registry data, and later studies, including meta-analyses, have concluded that there is no additional risk of cancer with these TNF inhibitors.

E.g. see:

https://pubmed.ncbi.nlm.nih.gov/24361468/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2770105/

[spenrose]

A co-author of the first study is employed by Humira's maker; the second study was funded by it. Doesn't mean they are wrong, but it does suggest some skepticism is due.

[atombender]

Those were only the first two studies that came up on PubMed. There are a number of studies that support the same conclusions.

[pazimzadeh]

Yes but that's one drug, which does increase your risk of infection according to your links. There are other newer drugs for which we don't have 20 years of data.

The best thing is if we could target these drugs to only be activated in areas of active inflammation.

[atombender]

Yes, we have less data on newer drugs, but TNF inhibitors are currently the go-to medication for many autoimmune disorders, including Crohn's and UC.

Infection risk is currently the case with all current medications that act on the immune system. In all cases we are merely suppressing some pathway where the end goal is to reduce the immune response.

ThatMs really the best we can do until we actually identify the causes, and can address that rather than "dialing down" our immune systems.

[pazimzadeh]

Yes. My point is that we should try to get the drugs to home to the inflamed regions somehow.