Risk of infections of biological and targeted drugs in patients with spondyloarthritis: meta-analysis of randomized clinical trials

Hu, Lin; Man, Siliang; Ji, Xiaojian; Wang, Yiwen; Liu, Xingkang; Zhang, Jiaxin; Song, Chuan; Zhu, Jin; Huang, Feng

doi:10.1097/cm9.0000000000001928

Cited by 2 publications

(2 citation statements)

References 26 publications

(51 reference statements)

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“…Le traitement de première intention correspond à la corticothérapie inhalée (CSI), permettant un contrôle de la maladie dans la majorité des cas 21 Les anti-TNF, anti-IL17 30 et JAKi (TOFACITINIB et UPADACITINIB) 31 35 . A partir des registres de la « vraie vie», on peut noter une incidence des infections sévères de 5,5/100 personnes-années pour les anti-TNFα (versus 2,7/100 personnes-années avec les csDMARD) 36 , 4,7/100 personnes-années avec le TOCILIZUMAB 37 , 4,1/100 personnesannées avec l'ABATACEPT 38 et 5,0/100 personnes-années pour le RITUXIMAB 39 dans la spondylarthrite axiale), JAKi (OR 2,0 [IC95% 0,8-4,9] dans le rhumatisme psoriasique et OR 7,5 [IC95% 0,2-381,0] dans la spondylarthrite axiale) ou anti-IL23 (OR 0,8 [IC95% 0,2-3,6] dans le rhumatisme psoriasique) 42 .…”

Section: Traitementsunclassified

Efficacité et tolérance d’une association de traitements ciblés indiqués pour l’asthme et pour les rhumatismes inflammatoires chroniques

Etronnier,

Bourdin,

Lukas

et al. 2023

Revue du Rhumatisme

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Section: Traitementsunclassified

Efficacité et tolérance d’une association de traitements ciblés indiqués pour l’asthme et pour les rhumatismes inflammatoires chroniques

Etronnier,

Bourdin,

Lukas

et al. 2023

Revue du Rhumatisme

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“…Кроме того, частота инфекций указанной локализации при назначении ГИБП была значимо выше, чем у больных, которые не получали эти препараты, что согласуется с данными других авторов. В частности, в метаанализе, выполненном китайскими учеными, риск инфекций верхних ДП у больных СпА, получавших ГИБП и таргетные БПВП, в целом был повышен в 1,17 раза, а у пациентов с аксиальным СпА на фоне терапии иФНОα -в 1,37 раза [11]. В другом исследовании использование ИНФ у больных СпА являлось независимым фактором риска развития внебольничной пневмонии, требующей госпитализации (относительный риск, ОР 2,55; p=0,04), в то время как связи между лечением БПВП и развитием тяжелой внебольничной пневмонии не выявлено [12].…”

unclassified

Comorbid infections in patients with spondyloarthritis: frequency, structure and risk factors

Baranova,

Muravyeva,

Belov

et al. 2023

Sovremennaâ revmatologiâ

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Objective: To investigate the frequency, structure, and risk factors of comorbid infections (CI) in patients with spondyloarthritis (SpA).Material and methods. The study included 332 patients with SpA. Patients were interviewed by the investigating physician, and additional information was obtained from medical records.Results and discussion. Respiratory tract (RT) and ear, nose, and throat (ENT) infections ranked first in the structure of CI. Exacerbation of SpA after CI was found in 42% of patients, and more severe CI against the background of SpA was found in 83 patients. 63 cases of severe CI (SCI) were documented, 63.5% of which were infections of the RT and ENT organs. Predictors for the development of lower RT (LRT) and ENT organ infections were the use of biologic disease-modifying antirheumatic drugs (bDMARDs) in general (odds ratio, OR 2.018; 95% confidence interval, CI 1.221-3.335; p=0.006 and OR 1.761; 95% CI 1.1-2.819, respectively; p=0.018) and tumor necrosis factor-α (TNF-α) inhibitors in particular (OR 2.376; 95% CI 1.417-3.983; p=0.001 and OR 1.833; 95% CI 1.123-2.994; p=0.015), and disease duration of more than 5 years (OR 1.774; 95% CI 1.034—3.042; p=0.037 and OR 2.22; 95% CI 1.378-3.576; p=0.001). The risk of developing LRT infection was higher in the presence of chronic lung disease (OR 3.673; 95% CI 1.602-8.425; p=0.002) and Charlesson Comorbidity Index ≥1 (OR 2.381; 95% CI 1.439-3.94; p=0.001), risk of developing ENT organ infections - with the use of >1 bDMARD (OR 2.4; 95% CI 1.199-4.804; p=0.013) and duration of methotrexate therapy over 5 years (OR 2.478; 95% CI 1.053-5.831; p=0.038). Risk factors for the development of SCI were the use of bDMARDs in general (OR 1.941; 95% CI 1.063-3.545; p=0.031) and TNFα in particular (OR 2.246; 95%, CI 1.218-4.139; p=0.01).Conclusion. The problem of CI in SpA is of great importance. The vast majority of patients with SpA should be vaccinated against pneumococcal infection and influenza.

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Risk of infections of biological and targeted drugs in patients with spondyloarthritis: meta-analysis of randomized clinical trials

Cited by 2 publications

References 26 publications

Efficacité et tolérance d’une association de traitements ciblés indiqués pour l’asthme et pour les rhumatismes inflammatoires chroniques

Efficacité et tolérance d’une association de traitements ciblés indiqués pour l’asthme et pour les rhumatismes inflammatoires chroniques

Comorbid infections in patients with spondyloarthritis: frequency, structure and risk factors

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