Portal de investigação
Opportunistic Infections in Patients with Inflammatory Bowel Disease Treated with Advanced Therapies: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Autores da FMUP
Participantes de fora da FMUP
- Olivera, PA
- Lasa, JS
- Zubiaurre, I
- Jairath, V
- Abreu, MT
- Rubin, DT
- Reinisch, W
- Rahier, JF
- Danese, S
- Rabaud, C
- Peyrin-Biroulet, L
Unidades de investigação
Abstract
Background and Aims Advanced therapies for inflammatory bowel disease [IBD] could potentially lead to a state of immunosuppression with an increased risk of opportunistic infections [OIs]. We aimed to provide an update on the incidence of OIs among adult IBD patients in randomized controlled trials [RCTs] of approved biologics and small-molecule drugs [SMDs]. Also, we aimed to describe OI definitions utilized in RCTs, to ultimately propose a standardized definition. Methods Electronic databases were searched from January 1, 1990, until April 16, 2022. Our primary outcome was incidence rate of overall OIs among IBD patients exposed and unexposed to biologics or SMDs. We also describe specific OIs reported in included trials, as well as definitions of OIs within studies when provided. Results Ninety studies were included. The incidence rates of reported OIs were 0.42 and 0.21 per 100 person-years in patients exposed to advanced therapies and placebo, respectively. This was highest for anti-tumour necrosis factors [0.83 per 100 person-years] and Janus kinase inhibitors [0.55 per 100 person-years] and lowest for anti-integrins and ozanimod. On meta-analysis, no increased risk of OIs was observed. None of the studies provided a detailed definition of OIs, or a comprehensive list of infections considered as OIs. Conclusion Different mechanisms of action may have specific OI profiles. In the absence of a uniform definition of OIs, these estimates are less reliable. We propose a definition to be used in future studies to help provide standardized reporting. When using this definition, we saw significant differences in incidence rates of OIs across mechanisms of action.
Dados da publicação
- ISSN/ISSNe:
- 1873-9946, 1876-4479
- Tipo:
- Review
- Páginas:
- 199-210
- Link para outro recurso:
- www.scopus.com
JOURNAL OF CROHNS & COLITIS Oxford University Press
Citações Recebidas na Web of Science: 4
Citações Recebidas na Scopus: 6
Documentos
- Não há documentos
Filiações
Keywords
- Opportunistic infections; biologic; small-molecule drugs
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Citar a publicação
Olivera PA,Lasa JS,Zubiaurre I,Jairath V,Abreu MT,Rubin DT,Reinisch W,Magro F,Rahier JF,Danese S,Rabaud C,Peyrin L. Opportunistic Infections in Patients with Inflammatory Bowel Disease Treated with Advanced Therapies: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J. Crohn's Colitis. 2023. 17(2):p. 199-210. IF:8,000. (1).
