The risk of infection and malignancy with tumor necrosis factor antagonists in adults with psoriatic disease: a systematic review and meta-analysis of randomized controlled trials.
The risk of infection and malignancy with tumor necrosis factor antagonists in adults with psoriatic disease: a systematic review and meta-analysis of randomized controlled trials.
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DOI：
10.1016/j.jaad.2010.09.734
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发表时间：
2011-06
影响因子：
13.8
通讯作者：
Gelfand, Joel M.
中科院分区：
文献类型：
--
作者：
Dommasch, Erica D.;Abuabara, Katrina;Shin, Daniel B.;Josephine Nguyen;Troxel, Andrea B.;Gelfand, Joel M.
关键词：
有必要更好地了解肿瘤坏死因子抑制剂在银屑病患者中的安全性，在银屑病患者中，肿瘤坏死因子抑制剂经常被用作单一疗法。在成年银屑病患者中使用肿瘤坏死因子拮抗剂，检查感染和恶性肿瘤的风险。对治疗成人斑块型牛皮癣(PSO)和牛皮癣关节炎(PSA)的肿瘤坏死因子拮抗剂进行系统研究。我们纳入了治疗PSO和PSA的依那西普、英夫利昔单抗、阿达利单抗、Golimumab和certolizumab的随机、安慰剂对照试验。在总计6810名患者的820项已确定研究中，有20项纳入其中。结果使用固定效应模型计算，并报告为合并优势比(OR)。总感染和严重感染的OR值分别为1.18(95%CI：1.05，1.33)和0.70(95%CI：0.40，1.21)。调整患者年数后，总感染发生率比为1.01(95%CI：0.92，1.11)。恶性肿瘤的OR值为1.48(95%CI：0.71，3.09)，排除非黑色素瘤皮肤癌的OR值为1.26(95%CI：0.39，4.15)。随访时间短，罕见的恶性肿瘤和严重感染。短期使用肿瘤坏死因子拮抗剂治疗牛皮癣，总体感染风险略有增加，这可能是由于治疗组和安慰剂组在随访时间上的差异。没有证据表明严重感染的风险增加，短期使用肿瘤坏死因子抑制剂也没有观察到癌症风险的统计学显着增加。
There is a need to better understand the safety of TNF inhibitors in patients with psoriatic disease in whom TNF inhibitors are frequently used as monotherapy. Examine the risks of infection and malignancy with the use of TNF antagonists in adult patients with psoriatic disease. Systematic search for trials of TNF antagonists for adults with plaque psoriasis (PsO) and psoriatic arthritis (PsA). We included randomized, placebo-controlled trials of etanercept, infliximab, adalimumab, golimumab, and certolizumab for the treatment of PsO and PsA. 20 out of 820 identified studies with a total of 6,810 patients were included. Results were calculated using fixed effects models and reported as pooled odds ratios (OR). ORs for overall infection and serious infection over a mean of 17.8 weeks were 1.18 (95% CI: 1.05, 1.33) and 0.70 (95% CI: 0.40, 1.21), respectively. When adjusting for patient-years, the incidence rate ratio for overall infection was 1.01 (95% CI: 0.92, 1.11). The OR for malignancy was 1.48 (95% CI: 0.71, 3.09), and 1.26 (95% CI: 0.39, 4.15) when non-melanoma skin cancer was excluded. Short duration of follow-up and rarity of malignancies and serious infections. There is a small increased risk of overall infection with the short-term use of TNF antagonists for psoriasis that may be attributable to differences in follow-up time between treatment and placebo groups. There was no evidence of an increased risk of serious infection and a statistically significant increased risk in cancer was not observed with short-term use of TNF inhibitors.
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影响因子：
120.7
作者：
Gelfand, Joel M.;Neimann, Andrea L.;Troxel, Andrea B.
通讯作者：
Troxel, Andrea B.
影响因子：
--
作者：
Gómez-Reino, JJ;Carmona, L;Montero, MD
通讯作者：
Montero, MD
影响因子：
13.8
作者：
Gelfand, JM;Feldman, SR;Margolis, DJ
通讯作者：
Margolis, DJ
DOI：
10.1111/j.1365-2133.2010.09941.x
发表时间：
2010-09
期刊：
The British journal of dermatology
影响因子：
--
作者：
Abuabara K;Azfar RS;Shin DB;Neimann AL;Troxel AB;Gelfand JM
通讯作者：
Gelfand JM
影响因子：
--
作者：
Antoni, CE;Kavanagh, A;Smolen, J
通讯作者：
Smolen, J