Treating IBD with Humira, Remicade May Increase Risk of Kidney Damage: Study

Side effects of Humira, Remicade and similar rheumatoid arthritis drugs reduced kidney functioning in many IBD patients, making them equivalent to kidneys found in much older patients

The side effects of certain anti-inflammation drugs, such as the blockbuster treatments Humira and Remicade, may degrade kidney function, according to the findings of a new study.

In a report published this week in the medical journal JAMA Network Open, researchers indicate that data from U.S. Department of Veterans Affairs suggests that individuals taking anti-tumor necrosis factor (TNF) therapy drugs experienced to a 30% drop in kidney function, when the popular medications were taken for treatment of irritable bowel disease (IBD).

TNF inhibitors are some of the best-selling drugs on the market in the U.S., including Humira, Enbrel, Remicade, Cimzia and Simponi, which are common therapies for certain autoimmune diseases, including rheumatoid arthritis, juvenile arthritis, psoriatic arthritis, ulcerative colitis, Crohn’s disease and others. The class of medications is projected to generate combined sales of more than $40 billion a year by 2026.

Prior studies have raised concerns that side effects of Humira and similar TNF inhibitor drugs may increase the risk of nerve damage, and the drugs caused more injuries to patients than any other medication in 2014. Another study published in 2022 linked the use of drugs like Humira to an increased risk of developing psoriasis, a condition the medication is often prescribed to treat.

Researchers hypothesize TNF inhibitors may worsen an immune response that is already abnormal, such as with IBD; a chronic intestinal condition which can cause abdominal pain, bloating, gas, diarrhea or constipation. The causes of IBD are not well understood, but the condition can often be controlled through diet, lifestyle changes and medication.

In this latest study, researchers from the University of Tennessee Health Science Center analyzed data from the U.S. Department of Veterans Affairs healthcare system from October 2004 to September 2019. This included more than 10,000 veterans newly diagnosed with irritable bowel disease (IBD), of which 14% recently began using anti-TNF therapy.

According to the data, TNF inhibitors were linked with a higher risk of reduced kidney function, but not an increased risk of death.

Researchers determined that more than 3,300 patients experienced at least a 30% drop in kidney function, making them the equivalent of kidneys found in an elderly patient, despite being much younger. At least 2,500 patients in the study died, though the researchers do not claim those deaths were directly linked to Humira, Remicade or Enbrel use.

However, the researchers determined the use of TNF inhibitors was “significantly linked” with impaired kidney function..

“These findings suggest potentially distinct pathophysiologic contributions of TNF inhibitor use associated with kidney outcomes in patients with IBD and that there is a need for careful monitoring of kidney function when initiating anti-TNF therapy in patients with incident IBD,” the researchers concluded. “Further studies are needed to confirm findings and to examine potentially distinct pathophysiologic contributions of incident TNF inhibitor use to kidney and nonkidney outcomes in patients with IBD.”