Infections in Biological and Targeted Synthetic Drug Use in Rheumatoid Arthritis: Where do We Stand? A Scoping Review and Meta-analysis.

Autor: Bergmans BJM; Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands. b.j.m.bergmans@tilburguniversity.edu.; Department of Medical Microbiology and Immunology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands. b.j.m.bergmans@tilburguniversity.edu.; Microvida, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands. b.j.m.bergmans@tilburguniversity.edu., Gebeyehu BY; Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.; Department of Methodology and Statistics, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands., van Puijenbroek EP; Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands.; University of Groningen, Groningen Research Institute of Pharmacy, PharmacoTherapy, Epidemiology & Economics, Groningen, The Netherlands., Van Deun K; Department of Methodology and Statistics, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands., Kleinberg B; Department of Methodology and Statistics, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands., Murk JL; Department of Medical Microbiology and Immunology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.; Microvida, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands., de Vries E; Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.; Department of Medical Microbiology and Immunology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.
Jazyk: angličtina
Zdroj: Rheumatology and therapy [Rheumatol Ther] 2023 Oct; Vol. 10 (5), pp. 1147-1165. Date of Electronic Publication: 2023 Jun 26.
DOI: 10.1007/s40744-023-00571-z
Abstrakt: Introduction: The advent of biological and targeted synthetic therapies has revolutionized rheumatoid arthritis (RA) treatment. However, this has come at the price of an increased risk of infections. The aim of this study was to present an integrated overview of both serious and non-serious infections, and to identify potential predictors of infection risk in RA patients using biological or targeted synthetic drugs.
Methods: We systematically reviewed available literature from PubMed and Cochrane and performed multivariate meta-analysis with meta-regression on the reported infections. Randomized controlled trials and prospective and retrospective observational studies including patient registry studies were analyzed, combined as well as separately. We excluded studies focusing on viral infections only.
Results: Infections were not reported in a standardized manner. Meta-analysis showed significant heterogeneity that persisted after forming subgroups by study design and follow-up duration. Overall, the pooled proportions of patients experiencing an infection during a study were 0.30 (95% CI, 0.28-0.33) and 0.03 (95% CI, 0.028-0.035) for any kind of infections or serious infections only, respectively. We found no potential predictors that were consistent across all study subgroups.
Conclusions: The high heterogeneity and the inconsistency of potential predictors between studies show that we do not yet have a complete picture of infection risk in RA patients using biological or targeted synthetic drugs. Besides, we found non-serious infections outnumbered serious infections by a factor 10:1, but only a few studies have focused on their occurrence. Future studies should apply a uniform method of infectious adverse event reporting and also focus on non-serious infections and their impact on treatment decisions and quality of life.
(© 2023. The Author(s).)
Databáze: MEDLINE
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