Risk of Infections and Cancer in Patients With Rheumatologic Diseases Receiving Interleukin Inhibitors: A Systematic Review and Meta-analysis.
Antibodies, Monoclonal
/ therapeutic use
Antirheumatic Agents
/ therapeutic use
Dermatologic Agents
/ therapeutic use
Gastrointestinal Agents
/ therapeutic use
Humans
Incidence
Interleukins
/ antagonists & inhibitors
Neoplasms
/ epidemiology
Opportunistic Infections
/ epidemiology
Randomized Controlled Trials as Topic
Rheumatic Diseases
/ drug therapy
Risk Assessment
Journal
JAMA network open
ISSN: 2574-3805
Titre abrégé: JAMA Netw Open
Pays: United States
ID NLM: 101729235
Informations de publication
Date de publication:
02 10 2019
02 10 2019
Historique:
entrez:
19
10
2019
pubmed:
19
10
2019
medline:
17
6
2020
Statut:
epublish
Résumé
The safety profile of interleukin (IL) inhibitors is not well established. To assess the risk of serious infections, opportunistic infections, and cancer in patients with rheumatologic diseases treated with IL inhibitors. Ovid MEDLINE and Epub Ahead of Print, In-Process & Other Non-Indexed Citations; Ovid MEDLINE Daily; Ovid Embase; Ovid Cochrane Central Register of Controlled Trials; Ovid Cochrane Database of Systematic Reviews; and Scopus were searched (inception to November 30, 2018). Randomized, placebo-controlled trials that evaluated IL inhibitor therapies in rheumatic diseases and reported safety data were included in the analyses. This systematic review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Two investigators independently extracted study data and assessed risk of bias and certainty in the evidence. Fixed-effects meta-analysis was conducted to pool odds ratios (ORs) for serious infections, opportunistic infections, and cancers for IL inhibitors vs placebo. The outcomes of interest were the number of serious infections, opportunistic infections, and cancers in individuals receiving IL inhibitor therapies compared with placebo. In this meta-analysis, 74 studies comprising 29 214 patients (24 236 patients for serious infections, 9998 for opportunistic infections, and 21 065 for cancer [number of patients overlaps for each outcome]) were included. Patients receiving IL inhibitors had a higher risk of serious infections (OR, 1.97; 95% CI, 1.58-2.44; P < .001, I2 = 0%; high certainty), opportunistic infections (OR, 2.35; 95% CI, 1.09-5.05; P = .03, I2 = 0%; moderate certainty), and cancer (OR, 1.52; 95% CI, 1.05-2.19; P = .03, I2 = 11%; moderate certainty). The risk of serious infections, opportunistic infections, and cancer appears to be increased in patients with rheumatologic diseases who are treated with IL inhibitors compared with placebo.
Identifiants
pubmed: 31626313
pii: 2753245
doi: 10.1001/jamanetworkopen.2019.13102
pmc: PMC6813598
doi:
Substances chimiques
Antibodies, Monoclonal
0
Antirheumatic Agents
0
Dermatologic Agents
0
Gastrointestinal Agents
0
Interleukins
0
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e1913102Commentaires et corrections
Type : ErratumIn
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