Daniel Holanda Barroso1, Jurema Guerrieri Brandão2, Elaine Silva Nascimento Andrade2,3, Ana Clara Banhatto Correia4, Danielle Costa Aquino5, Ana Carolina Rios Chen6, Sebastian Vernal7,8, Wildo Navegantes de Araújo3,9,10, Lícia Maria Henrique da Mota5, Raimunda Nonata Ribeiro Sampaio5, Patrícia Shu Kurizky5, Ciro Martins Gomes11,12,13. 1. Programa de Pós-Graduação em Ciências Médicas, Faculdade de Medicina, Universidade de Brasília - UnB, Campus Universitário Darcy Ribeiro, Brasília, DF, CEP 70910-900, Brazil. danielhbarroso@unb.br. 2. Departamento de Doenças de Condições Crônicas e Infecções Sexualmente Transmissíveis - DCCI, Coordenação Geral de Vigilância das Doenças em Eliminação - CGDE, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Brazil. 3. Programa de Pós-Graduação em Saúde Coletiva, Faculdade de Medicina, Universidade de Brasília - UnB, Brasília, Brazil. 4. Faculdade de Medicina de Petrópolis, Petrópolis, Brazil. 5. Programa de Pós-Graduação em Ciências Médicas, Faculdade de Medicina, Universidade de Brasília - UnB, Campus Universitário Darcy Ribeiro, Brasília, DF, CEP 70910-900, Brazil. 6. Faculdade de Medicina, Universidade de Brasília - UnB, Brasília, Brazil. 7. Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil. 8. Departamento de Clínica Médica, Divisão de Dermatologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil. 9. Programa de Pós-Graduação em Medicina Tropical, Núcleo de Medicina Tropical, Universidade de Brasília - UnB, Brasília, Brazil. 10. National Institute for Science and Technology for Health Technology Assessment (IATS), Porto Alegre, RS, Brazil. 11. Programa de Pós-Graduação em Ciências Médicas, Faculdade de Medicina, Universidade de Brasília - UnB, Campus Universitário Darcy Ribeiro, Brasília, DF, CEP 70910-900, Brazil. cirogomes@unb.br. 12. Faculdade de Medicina, Universidade de Brasília - UnB, Brasília, Brazil. cirogomes@unb.br. 13. Programa de Pós-Graduação em Medicina Tropical, Núcleo de Medicina Tropical, Universidade de Brasília - UnB, Brasília, Brazil. cirogomes@unb.br.
Abstract
BACKGROUND: Recently developed immunosuppressive drugs, especially TNF antagonists, may enhance the risk of granulomatous infections, including leprosy. We aimed to evaluate the leprosy detection rate in patients under immunosuppression due to rheumatological, dermatological and gastroenterological diseases. METHODS: We performed a systematic review of the literature by searching the PubMed, EMBASE, LILACS, Web of Science and Scielo databases through 2018. No date or language restrictions were applied. We included all articles that reported the occurrence of leprosy in patients under medication-induced immunosuppression. RESULTS: The search strategy resulted in 15,103 articles; finally, 20 articles were included, with 4 reporting longitudinal designs. The detection rate of leprosy ranged from 0.13 to 116.18 per 100,000 patients/year in the USA and Brazil, respectively. In the meta-analysis, the detection rate of cases of leprosy per 100,000 immunosuppressed patients with rheumatic diseases was 84 (detection rate = 0.00084; 95% CI = 0.0000-0.00266; I2 = 0%, p = 0.55). CONCLUSION: Our analysis showed that leprosy was relatively frequently detected in medication-induced immunosuppressed patients suffering from rheumatological diseases, and further studies are needed. The lack of an active search for leprosy in the included articles precluded more precise conclusions. TRIAL REGISTRATION: This review is registered in PROSPERO with the registry number CRD42018116275 .
BACKGROUND: Recently developed immunosuppressive drugs, especially TNF antagonists, may enhance the risk of granulomatous infections, including leprosy. We aimed to evaluate the leprosy detection rate in patients under immunosuppression due to rheumatological, dermatological and gastroenterological diseases. METHODS: We performed a systematic review of the literature by searching the PubMed, EMBASE, LILACS, Web of Science and Scielo databases through 2018. No date or language restrictions were applied. We included all articles that reported the occurrence of leprosy in patients under medication-induced immunosuppression. RESULTS: The search strategy resulted in 15,103 articles; finally, 20 articles were included, with 4 reporting longitudinal designs. The detection rate of leprosy ranged from 0.13 to 116.18 per 100,000 patients/year in the USA and Brazil, respectively. In the meta-analysis, the detection rate of cases of leprosy per 100,000 immunosuppressed patients with rheumatic diseases was 84 (detection rate = 0.00084; 95% CI = 0.0000-0.00266; I2 = 0%, p = 0.55). CONCLUSION: Our analysis showed that leprosy was relatively frequently detected in medication-induced immunosuppressed patients suffering from rheumatological diseases, and further studies are needed. The lack of an active search for leprosy in the included articles precluded more precise conclusions. TRIAL REGISTRATION: This review is registered in PROSPERO with the registry number CRD42018116275 .
Authors: Daniele S Freitas; Natalia Machado; Fernando V Andrigueti; Edgard T Reis Neto; Marcelo M Pinheiro Journal: Rev Bras Reumatol Date: 2010 May-Jun
Authors: Maria Stella Cochrane Feitosa; Gabriela Profírio Jardim Santos; Selma Regina Penha Silva Cerqueira; Gabriel Lima Rodrigues; Licia Maria Henrique da Mota; Ciro Martins Gomes Journal: Front Med (Lausanne) Date: 2022-04-25