The risk of respiratory tract infections and interstitial lung disease with interleukin 12/23 and interleukin 23 antagonists in patients with autoimmune diseases: A systematic review and meta-analysis - 15/02/21
Abstract |
Background |
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.
Objective |
To assess the risk of RTIs and noninfectious ILD with these drugs.
Methods |
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.
Results |
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.
Limitations |
Because of the rarity of infectious pneumonia and ILD, sensitivity analysis was required.
Conclusions |
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
Plan
| Funding sources: None. |
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| Conflicts of interest: None disclosed. |
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| IRB approval status: Not applicable. |
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| Reprints not available from the authors. |
Vol 84 - N° 3
P. 676-690 - mars 2021 Retour au numéro
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