Acute respiratory viral adverse events during use of antirheumatic disease therapies: A scoping review.
Acute respiratory viral adverse events during use of antirheumatic disease therapies: A scoping review.
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DOI：
10.1016/j.semarthrit.2020.07.007
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发表时间：
2020-10
影响因子：
5
通讯作者：
Jayatilleke A
中科院分区：
文献类型：
--
作者：
Kilian A;Chock YP;Huang IJ;Graef ER;Upton LA;Khilnani A;Krupnikova SDS;Almaghlouth I;Cappelli LC;Fernandez-Ruiz R;Frankel BA;Frankovich J;Harrison C;Kumar B;Monga K;Vega JAR;Singh N;Sparks JA;Sullo E;Young KJ;Duarte-Garcia A;Putman M;Johnson S;Grainger R;Wallace ZS;Liew JW;Jayatilleke A
COVID-19是一种急性呼吸道病毒感染，威胁着全世界的人们，包括风湿病患者，尽管目前尚不清楚各种抗风湿病疗法在多大程度上增加了病毒性呼吸道感染并发症的易感性。本研究对与抗风湿病治疗相关的急性呼吸道病毒不良事件的频率和严重程度的现有证据进行了范围审查。自数据库建立以来，在线数据库被用于识别报告使用抗风湿病治疗的患者急性呼吸道病毒感染的原始数据的研究。独立审稿人对使用标准化数据抽象工具绘制符合条件研究的数据图表。共有180项研究符合定性分析的条件。虽然承认现有文献在报告急性病毒感染或其并发症方面缺乏特异性，但数据表明，糖皮质激素、JAK抑制剂（特别是高剂量）、TNF抑制剂和抗il -17药物的使用可能与呼吸道病毒事件的频率增加有关。现有数据显示，使用非甾体抗炎药、羟氯喹、磺胺嘧啶、甲氨蝶呤、硫唑嘌呤、霉酚酸酯、环磷酰胺或阿普米司特不会增加呼吸道病毒事件的发生频率或风险。一项大型队列研究表明，与不使用来氟米特相比，使用来氟米特与急性病毒性呼吸事件风险增加有关。这一范围审查确定了一些药物类别可能会增加急性呼吸道病毒感染的风险。然而，缺乏明确的数据，未来的研究应该解决这一知识差距。
COVID-19 is an acute respiratory viral infection that threatens people worldwide, including people with rheumatic disease, although it remains unclear to what extent various antirheumatic disease therapies increase susceptibility to complications of viral respiratory infections. The present study undertakes a scoping review of available evidence regarding the frequency and severity of acute respiratory viral adverse events related to antirheumatic disease therapies. Online databases were used to identify, since database inception, studies reporting primary data on acute respiratory viral infections in patients utilizing antirheumatic disease therapies. Independent reviewer pairs charted data from eligible studies using a standardized data abstraction tool. A total of 180 studies were eligible for qualitative analysis. While acknowledging that the extant literature has a lack of specificity in reporting of acute viral infections or complications thereof, the data suggest that use of glucocorticoids, JAK inhibitors (especially high-dose), TNF inhibitors, and anti-IL-17 agents may be associated with an increased frequency of respiratory viral events. Available data suggest no increased frequency or risk of respiratory viral events with NSAIDs, hydroxychloroquine, sulfasalazine, methotrexate, azathioprine, mycophenolate mofetil, cyclophosphamide, or apremilast. One large cohort study demonstrated an association with leflunomide use and increased risk of acute viral respiratory events compared to non-use. This scoping review identified that some medication classes may confer increased risk of acute respiratory viral infections. However, definitive data are lacking and future studies should address this knowledge gap.
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