Risk of infections using anti-TNF agents in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis : a systematic review and meta-analysis
INTRODUCTION: Five anti-tumor necrosis factor (anti-TNF) agents have received regulatory approval for use in rheumatology: adalimumab, golimumab, infliximab, certolizumab, and etanercept. Apart from their well-documented therapeutic value, it is still uncertain to what extent they are associated with an increased risk of infectious adverse events. Areas covered: We conducted a systematic review and meta-analysis of published randomized studies to determine the effect of anti-TNF drugs on the occurrence of infectious adverse events (serious infections; tuberculosis; opportunistic infections; any infection). We searched Medline, Embase, and the Cochrane Library up to May 2014 to identify eligible studies in adult patients with rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis that evaluated anti-TNF drugs compared with placebo or no treatment. Expert opinion: Our study encompassed data from 71 randomized controlled trials involving 22,760 participants (range of follow-up: 1-36 months) and seven open label extension studies with 2,236 participants (range of follow-up: 6-48 months). Quantitative synthesis of the available data found statistically significant increases in the occurrence of any infections (20%), serious infections (40%), and tuberculosis (250%) associated with anti-TNF drug use, while the data for opportunistic infections were scarce. The quality of synthesized evidence was judged as moderate. Further evidence from registries and long-term epidemiological studies are needed to better define the relationship between anti-TNF agents and infection complications.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2016 |
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| Erschienen: |
2016 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:15 |
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| Enthalten in: |
Expert opinion on drug safety - 15(2016), sup1 vom: 06. Dez., Seite 11-34 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Minozzi, Silvia [VerfasserIn] |
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| Anmerkungen: |
Date Completed 27.02.2017 Date Revised 30.03.2022 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM266881629 |
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| 245 | 1 | 0 | |a Risk of infections using anti-TNF agents in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis |b a systematic review and meta-analysis |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a INTRODUCTION: Five anti-tumor necrosis factor (anti-TNF) agents have received regulatory approval for use in rheumatology: adalimumab, golimumab, infliximab, certolizumab, and etanercept. Apart from their well-documented therapeutic value, it is still uncertain to what extent they are associated with an increased risk of infectious adverse events. Areas covered: We conducted a systematic review and meta-analysis of published randomized studies to determine the effect of anti-TNF drugs on the occurrence of infectious adverse events (serious infections; tuberculosis; opportunistic infections; any infection). We searched Medline, Embase, and the Cochrane Library up to May 2014 to identify eligible studies in adult patients with rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis that evaluated anti-TNF drugs compared with placebo or no treatment. Expert opinion: Our study encompassed data from 71 randomized controlled trials involving 22,760 participants (range of follow-up: 1-36 months) and seven open label extension studies with 2,236 participants (range of follow-up: 6-48 months). Quantitative synthesis of the available data found statistically significant increases in the occurrence of any infections (20%), serious infections (40%), and tuberculosis (250%) associated with anti-TNF drug use, while the data for opportunistic infections were scarce. The quality of synthesized evidence was judged as moderate. Further evidence from registries and long-term epidemiological studies are needed to better define the relationship between anti-TNF agents and infection complications | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Ankylosing spondylitis | |
| 650 | 4 | |a anti-TNF drugs | |
| 650 | 4 | |a drug safety | |
| 650 | 4 | |a infections | |
| 650 | 4 | |a meta-analysis | |
| 650 | 4 | |a opportunistic infections | |
| 650 | 4 | |a psoriatic arthritis | |
| 650 | 4 | |a rheumatoid arthritis | |
| 650 | 4 | |a serious infections | |
| 650 | 4 | |a systematic review | |
| 650 | 4 | |a tuberculosis | |
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| 700 | 1 | |a Gabrielli, Eugenia Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Lonati, Andrea Carlo |e verfasserin |4 aut | |
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| 700 | 1 | |a Cinquini, Michela |e verfasserin |4 aut | |
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| 700 | 1 | |a Goletti, Delia |e verfasserin |4 aut | |
| 700 | 1 | |a Cantini, Fabrizio |e verfasserin |4 aut | |
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