OBJECTIVES: Infliximab (IFX) or adalimumab (ADA) use in patients with inflammatory bowel disease (IBD) leads to increased risk of tuberculosis (TB). This meta-analysis evaluated the factors which determine this risk, with special focus on local TB incidence. METHODS: All studies until January 31, 2019, which reported the development of TB in patients with IBD on IFX/ADA, were included after searching PubMed and Embase. Data regarding disease type, number of patients on IFX/ADA, number of patients who developed TB, mean age at IFX/ADA initiation, median duration of development of TB, and latent TB (LTB) were extracted. The details on local TB incidence were obtained from the World Health Organization database, and the studies were stratified into low (<10/100,000), intermediate (10-40/100,000), and high TB burden countries (>40/100,000). Random effect meta-analysis was performed to calculate the overall pooled prevalence and prevalence based on local TB burden. RESULTS: Of 130,114 patients (128 studies), 373 developed TB (pooled prevalence: 0.08% [95% confidence interval {CI}: 0.05%-0.10%]). The risk increased with increasing TB burden, pooled prevalence being 0.02% (95% CI: 0.02%-0.03%), 0.21% (95% CI: -0.02% to 0.43%), and 1.59% (95% CI: 1.19%-2.00%) for low, intermediate, and high TB burden countries, respectively. Seventy-three percent of patients who developed TB had no evidence of LTB on screening, the proportion being independent of TB burden. There was no effect of disease or treatment type, study type, gender, age at IFX/ADA initiation, and follow-up duration on TB prevalence. DISCUSSION: TB risk in patients with IBD on IFX/ADA depends on the local TB burden and is independent of disease/treatment type.
OBJECTIVES:Infliximab (IFX) or adalimumab (ADA) use in patients with inflammatory bowel disease (IBD) leads to increased risk of tuberculosis (TB). This meta-analysis evaluated the factors which determine this risk, with special focus on local TB incidence. METHODS: All studies until January 31, 2019, which reported the development of TB in patients with IBD on IFX/ADA, were included after searching PubMed and Embase. Data regarding disease type, number of patients on IFX/ADA, number of patients who developed TB, mean age at IFX/ADA initiation, median duration of development of TB, and latent TB (LTB) were extracted. The details on local TB incidence were obtained from the World Health Organization database, and the studies were stratified into low (<10/100,000), intermediate (10-40/100,000), and high TB burden countries (>40/100,000). Random effect meta-analysis was performed to calculate the overall pooled prevalence and prevalence based on local TB burden. RESULTS: Of 130,114 patients (128 studies), 373 developed TB (pooled prevalence: 0.08% [95% confidence interval {CI}: 0.05%-0.10%]). The risk increased with increasing TB burden, pooled prevalence being 0.02% (95% CI: 0.02%-0.03%), 0.21% (95% CI: -0.02% to 0.43%), and 1.59% (95% CI: 1.19%-2.00%) for low, intermediate, and high TB burden countries, respectively. Seventy-three percent of patients who developed TB had no evidence of LTB on screening, the proportion being independent of TB burden. There was no effect of disease or treatment type, study type, gender, age at IFX/ADA initiation, and follow-up duration on TB prevalence. DISCUSSION: TB risk in patients with IBD on IFX/ADA depends on the local TB burden and is independent of disease/treatment type.
Authors: Flora Maria Lorenzo Fortes; Ney Boa Sorte; Victor D Mariano; Laíla D Andrade; Fernanda A Oliveira; Monique Ca Santos; Cláudia Ivanilda N Dos Santos; Catharina A Passos; Mila P Pacheco; Valdiana C Surlo; Neogélia P de Almeida; Jaciane Am Fontes; Andréa M Pimentel; Raquel Rocha; Genoile Oliveira Santana Journal: World J Gastroenterol Date: 2020-11-28 Impact factor: 5.742
Authors: Sabino Riestra; Carlos Taxonera; Yamile Zabana; Daniel Carpio; María Chaparro; Jesús Barrio; Montserrat Rivero; Antonio López-Sanroman; María Esteve; Ruth de Francisco; Guillermo Bastida; Santiago García-López; Miriam Mañosa; María Dolores Martin-Arranz; José Lázaro Pérez-Calle; Jordi Guardiola; Fernando Muñoz; Laura Arranz; José Luis Cabriada; Mariana Fe García-Sepulcre; Mercè Navarro; Miguel Ángel Montoro-Huguet; Elena Ricart; Fernando Bermejo; Xavier Calvet; Marta Piqueras; Esther Garcia-Planella; Lucía Márquez; Miguel Mínguez; Manuel Van Domselar; Luis Bujanda; Xavier Aldeguer; Beatriz Sicilia; Eva Iglesias; Guillermo Alcaín; Isabel Pérez-Martínez; Valeria Rolle; Andrés Castaño-García; Javier P Gisbert; Eugeni Domènech Journal: J Clin Med Date: 2022-07-05 Impact factor: 4.964
Authors: Bahez Gareb; Antonius T Otten; Henderik W Frijlink; Gerard Dijkstra; Jos G W Kosterink Journal: Pharmaceutics Date: 2020-06-11 Impact factor: 6.321