Arthritis Treatment May Reactivate Virus Responsible for Some Lymphomas

[Guest guest]

Arthritis Treatment May Reactivate Virus Responsible for Some Lymphomas

17 Nov 2004

Methotrexate, a treatment for rheumatoid arthritis and polymyositis, may

promote the development of Epstein-Barr virus (EBV)-positive lymphomas in

patients with autoimmune diseases by reactivating latent EBV and by the

drug's immunosuppressive properties, according to a new study.

EBV is a human herpesvirus that is found in more than 90% of the adult

population. The virus establishes a lifelong persistent infection of B cells

and is associated with a variety of B-cell disorders, including

mononucleosis and Hodgkin lymphoma. EBV-positive lymphomas occur more

frequently in rheumatoid arthritis and polymyositis patients taking the drug

methotrexate than in patients treated with other equally immunosuppressive

drugs.

By studying the effect of methotrexate on EBV-infected cell lines,

Kenney, M.D. of the Lineberger Comprehensive Cancer Center at the University

of North Carolina Chapel Hill, and colleagues demonstrate that methotrexate

induces reactivation of EBV from latent infection, leading to the release of

infectious virions. The researchers also found that rheumatoid arthritis and

polymyositis patients treated with methotrexate had higher EBV loads than

patients treated with other immunosuppressive regimens. They conclude that

the combination of methotrexate's ability to induce EBV replication in such

patients while promoting immunosuppression might explain the association of

the drug with EBV-positive lymphomas.

Contact: Dianne Shaw, Lineberger Comprehensive Cancer Center, 919-966-5905,

dgs@...

Contact: L. Zielinski

jncimedia@...

301-841-1287

Journal of the National Cancer Institute

[Guest guest]

a, Is this something that is a concern if you are no longer on

Methotrexate or is it something you have to worry about because of

taking Mx? I was on it for a long time in a high dose (27 mg weekly).

I haven't been on it for over a year because of a problem with my

lungs that they thought might have been caused by the Mx. They are

still having trouble getting my RA under control. Started Remicade

with my first infusion today. Second round for Remicade. My Rhuemy

said I was never given a very large amount (different doctor first

time) have a much better Rhuemitologist this time.

in Central Oregon

[Guest guest]

a, Is this something that is a concern if you are no longer on

Methotrexate or is it something you have to worry about because of

taking Mx? I was on it for a long time in a high dose (27 mg weekly).

I haven't been on it for over a year because of a problem with my

lungs that they thought might have been caused by the Mx. They are

still having trouble getting my RA under control. Started Remicade

with my first infusion today. Second round for Remicade. My Rhuemy

said I was never given a very large amount (different doctor first

time) have a much better Rhuemitologist this time.

in Central Oregon

[Guest guest]

, I would ask your rheumatologist for some reassurance regarding

past MTX use and lymphoma.

People with RA, even those who aren't receiving DMARDs, are at higher

risk for lymphoma.

As this study shows, there is some evidence that MTX use in RA has an

association with the development of lymphoma. There have also been

questions regarding the anti-TNF therapies and lymphoma, too.

Unfortunately, nobody has any firm answers yet.

Are you taking another DMARD along with the Remicade since you are off

the MTX?

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

[ ] Re: Arthritis Treatment May Reactivate Virus

Responsible for Some Lymphomas

>

>

> a, Is this something that is a concern if you are no longer on

> Methotrexate or is it something you have to worry about because of

> taking Mx? I was on it for a long time in a high dose (27 mg weekly).

>

> I haven't been on it for over a year because of a problem with my

> lungs that they thought might have been caused by the Mx. They are

> still having trouble getting my RA under control. Started Remicade

> with my first infusion today. Second round for Remicade. My Rhuemy

> said I was never given a very large amount (different doctor first

> time) have a much better Rhuemitologist this time.

>

> in Central Oregon

[Guest guest]

, I would ask your rheumatologist for some reassurance regarding

past MTX use and lymphoma.

People with RA, even those who aren't receiving DMARDs, are at higher

risk for lymphoma.

As this study shows, there is some evidence that MTX use in RA has an

association with the development of lymphoma. There have also been

questions regarding the anti-TNF therapies and lymphoma, too.

Unfortunately, nobody has any firm answers yet.

Are you taking another DMARD along with the Remicade since you are off

the MTX?

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

[ ] Re: Arthritis Treatment May Reactivate Virus

Responsible for Some Lymphomas

>

>

> a, Is this something that is a concern if you are no longer on

> Methotrexate or is it something you have to worry about because of

> taking Mx? I was on it for a long time in a high dose (27 mg weekly).

>

> I haven't been on it for over a year because of a problem with my

> lungs that they thought might have been caused by the Mx. They are

> still having trouble getting my RA under control. Started Remicade

> with my first infusion today. Second round for Remicade. My Rhuemy

> said I was never given a very large amount (different doctor first

> time) have a much better Rhuemitologist this time.

>

> in Central Oregon