Respiratory tract infections (RTIs) and interstitial lung disease (ILD) secondary to interleukin (IL) 12/23 or IL-23 antagonists have been reported in autoimmune diseases.
To assess the risk of RTIs and noninfectious ILD with these drugs.
We conducted a systematic review and meta-analysis of randomized controlled trials. Risk of RTIs and noninfectious ILD was compared to placebo by Mantel-Haenszel risk difference. We divided RTIs into upper RTIs (URTI), viral URTIs, and lower RTIs (LRTIs) including infectious pneumonia. Noninfectious ILD included ILD, eosinophilic pneumonia, and pneumonitis.
We identified 54 randomized controlled trials including 10,907 patients with 6 IL-12/23 or IL-23 antagonists and 5175 patients with placebo. These drugs significantly increased the risk of RTIs (Mantel-Haenszel risk difference, 0.019; 95% confidence interval, 0.005-0.033; P = .007), which was attributed to URTIs, but not viral URTIs or LRTIs. There was no significant difference in infectious pneumonia and noninfectious ILD between 2 groups.
Because of the rarity of infectious pneumonia and ILD, sensitivity analysis was required.
The use of IL-12/23 or IL-23 antagonists for autoimmune diseases increased the risk of URTIs, but not viral URTIs, LRTIs, and noninfectious ILD.Le texte complet de cet article est disponible en PDF.
Key words : autoimmune diseases, IL12/23 and IL23 antagonists, meta-analysis, noninfectious interstitial lung disease, respiratory tract infections
Abbreviations used : CD, CI, FDA, IL, ILD, LRTI, MedDRA, MH, OR, RCT, RD, RR, RTI, URTI
| Funding sources: None.
| Conflicts of interest: None disclosed.
| IRB approval status: Not applicable.
| Reprints not available from the authors.