دورية أكاديمية
Risk of infections in psoriatic arthritis or axial spondyloarthritis patients treated with targeted therapies: A meta-analysis of randomized controlled trials.
| العنوان: | Risk of infections in psoriatic arthritis or axial spondyloarthritis patients treated with targeted therapies: A meta-analysis of randomized controlled trials. |
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| المؤلفون: | Séauve M; University of Lyon, University Lyon 1, 69100 Lyon, France; Department of Rheumatology, Lyon Sud Hospital, Hospices Civils de Lyon, 69495 Pierre-Bénite, France., Auréal M; University of Lyon, University Lyon 1, 69100 Lyon, France; Department of Rheumatology, Lyon Sud Hospital, Hospices Civils de Lyon, 69495 Pierre-Bénite, France., Laplane S; University of Lyon, University Lyon 1, 69100 Lyon, France; Department of Rheumatology, Lyon Sud Hospital, Hospices Civils de Lyon, 69495 Pierre-Bénite, France., Lega JC; University of Lyon, University Lyon 1, 69100 Lyon, France; Department of Internal and Vascular Medicine, Lyon Sud Hospital, Hospices Civils de Lyon, Pierre-Bénite, France; University of Lyon, UMR - CNRS 5558, Laboratoire de Biométrie et Biologie Évolutive, 69100 Lyon, France; Lyon Immunopathology Federation, Lyon, France., Cabrera N; University of Lyon, UMR - CNRS 5558, Laboratoire de Biométrie et Biologie Évolutive, 69100 Lyon, France., Coury F; University of Lyon, University Lyon 1, 69100 Lyon, France; Department of Rheumatology, Lyon Sud Hospital, Hospices Civils de Lyon, 69495 Pierre-Bénite, France; Lyon Immunopathology Federation, Lyon, France; University of Lyon, Inserm UMR 1033, 69100 Lyon, France. Electronic address: fabienne.coury-lucas@chu-lyon.fr. |
| المصدر: | Joint bone spine [Joint Bone Spine] 2024 May; Vol. 91 (3), pp. 105673. Date of Electronic Publication: 2023 Nov 30. |
| نوع المنشور: | Journal Article; Meta-Analysis |
| اللغة: | English |
| بيانات الدورية: | Publisher: Editions Elsevier Country of Publication: France NLM ID: 100938016 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1778-7254 (Electronic) Linking ISSN: 1297319X NLM ISO Abbreviation: Joint Bone Spine Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Paris : Editions Elsevier, c2000- |
| مواضيع طبية MeSH: | Antirheumatic Agents*/therapeutic use , Antirheumatic Agents*/adverse effects , Arthritis, Psoriatic*/drug therapy , Arthritis, Psoriatic*/complications , Randomized Controlled Trials as Topic* , Spondylarthritis*/drug therapy , Spondylarthritis*/complications, Female ; Humans ; Male ; Biological Products/therapeutic use ; Biological Products/adverse effects ; Infections/epidemiology ; Molecular Targeted Therapy/methods ; Risk Assessment |
| مستخلص: | Objective: To evaluate the risk of global infections in patients with psoriatic arthritis (PsA) and axial spondyloarthritis encompassing ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA) treated with targeted therapies. Methods: Medline and Cochrane databases were systematically searched up to March 2021 for randomized controlled trials (RCTs) performed in patients with PsA or axial spondyloarthritis treated with biologic or targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs). Global infections (any infections reported, including bacterial, viral and fungal infections, except serious infections) were the primary outcome. Secondary outcomes included serious infections defined as life-threatening infections or any infection requiring intravenous antibiotics or hospitalization. The relative risk of infections was determined by meta-analysis of RCTs. Results: A total of 60 RCTs were included (20,418 patients), encompassing 17 b/tsDMARDs, compared with placebo, conventional synthetic drugs (csDMARDs) or non-steroidal anti-inflammatory drugs (NSAIDs). An increased risk of any infection for patients exposed to these drugs was found (RR 1.15, 95% CI [1.06-1.25]), mainly with high doses and longer duration of treatment. Most infections were respiratory tract or ear, nose, and throat (ENT) infections. Subgroup analyses showed a statistically significant increased risk of infections for axial spondyloarthritis patients (RR 1.32, 95% CI [1.14-1.52]), but not for PsA patients (RR 1.05, 95% CI [0.97-1.14]). Infection risk was highest with TNF inhibitors (RR 1.23, 95% CI [1.11-1.37]) and IL-17 inhibitors (RR 1.30, 95% CI [1.07-1.59]). No increased risk of serious infections was shown. Conclusion: In contrast to serious infections, the risk of global infections is moderately increased with b/tsDMARDs in spondyloarthritis, and is associated in particular with use of TNF and IL-17 inhibitors. (Copyright © 2023 Société française de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Axial spondyloarthritis; Biologic and targeted synthetic therapies; Infections; Meta-analysis; Psoriatic arthritis; Relative risk |
| المشرفين على المادة: | 0 (Antirheumatic Agents) 0 (Biological Products) |
| تواريخ الأحداث: | Date Created: 20231202 Date Completed: 20240501 Latest Revision: 20240610 |
| رمز التحديث: | 20240610 |
| DOI: | 10.1016/j.jbspin.2023.105673 |
| PMID: | 38042364 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1778-7254 |
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| DOI: | 10.1016/j.jbspin.2023.105673 |