A meta – analysis of 18 randomized trials in 8808 subjects with rheumatoid arthritis treated with anti-TNF therapy [ 58 ] underlined that there was no significant differences in serious infections, malignancies and deaths between patients treated with metotrexate and those treated with recommended doses of anti-TNF, while the risk of serious infections was significantly higher when anti-TNF were administered at higher dosages and the risk of melanoma plus non cutaneous cancer tended toward significance. 6.2.2.
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