Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2016 Dec;15(sup1):11-34.
doi: 10.1080/14740338.2016.1240783.

Risk of infections using anti-TNF agents in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: a systematic review and meta-analysis

Silvia Minozzi  1 , Stefanos Bonovas  2 , Theodore Lytras  3   4   5 , Valentina Pecoraro  6 , Marien González-Lorenzo  7 , Anan Judina Bastiampillai  8 , Eugenia Maria Gabrielli  8 , Andrea Carlo Lonati  8 , Lorenzo Moja  6   7 , Michela Cinquini  9 , Valentina Marino  10 , Andrea Matucci  11 , Giuseppe Maria Milano  12 , Giuliano Tocci  13   14 , Raffaele Scarpa  15 , Delia Goletti  16 , Fabrizio Cantini  17
Affiliations
Free article
Review

Risk of infections using anti-TNF agents in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: a systematic review and meta-analysis

Silvia Minozzi et al. Expert Opin Drug Saf. 2016 Dec.
Free article

Abstract

Five anti-tumor necrosis factor (anti-TNF) agents have received regulatory approval for use in rheumatology: adalimumab, golimumab, infliximab, certolizumab, and etanercept. Apart from their well-documented therapeutic value, it is still uncertain to what extent they are associated with an increased risk of infectious adverse events. Areas covered: We conducted a systematic review and meta-analysis of published randomized studies to determine the effect of anti-TNF drugs on the occurrence of infectious adverse events (serious infections; tuberculosis; opportunistic infections; any infection). We searched Medline, Embase, and the Cochrane Library up to May 2014 to identify eligible studies in adult patients with rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis that evaluated anti-TNF drugs compared with placebo or no treatment. Expert opinion: Our study encompassed data from 71 randomized controlled trials involving 22,760 participants (range of follow-up: 1-36 months) and seven open label extension studies with 2,236 participants (range of follow-up: 6-48 months). Quantitative synthesis of the available data found statistically significant increases in the occurrence of any infections (20%), serious infections (40%), and tuberculosis (250%) associated with anti-TNF drug use, while the data for opportunistic infections were scarce. The quality of synthesized evidence was judged as moderate. Further evidence from registries and long-term epidemiological studies are needed to better define the relationship between anti-TNF agents and infection complications.

Keywords: Ankylosing spondylitis; anti-TNF drugs; drug safety; infections; meta-analysis; opportunistic infections; psoriatic arthritis; rheumatoid arthritis; serious infections; systematic review; tuberculosis.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

MeSH terms

Substances

-