Open Access

Risk of tuberculosis during infliximab therapy for inflammatory bowel disease, rheumatoid arthritis, and spondyloarthropathy: A meta-analysis

  • Authors:
    • Qiang Wang
    • Zhenzhen Wen
    • Qian Cao
  • View Affiliations

  • Published online on: July 26, 2016     https://doi.org/10.3892/etm.2016.3548
  • Pages: 1693-1704
  • Copyright: © Wang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Infliximab is a promising drug with good outcomes demonstrated for diseases such as inflammatory bowel disease (IBD), rheumatoid arthritis (RA) and spondyloarthropathy (SpA). However, treatment with this drug may increase the risk of tuberculosis infection. The aim of the present study was to investigate infliximab‑associated tuberculosis infection. Literature searches in PubMed, MEDLINE and EMBASE databases were performed. Randomized controlled trials with >95% of the patients >18 years-old were included. Meta‑analysis was performed to investigate the incidence of tuberculosis infection after infliximab infusion. A total of 24 RCTs were included in the present meta‑analysis. In total, 21 (0.51%) tuberculosis infections were detected among 4,111 patients administered infliximab therapy, compared with 0 (0%) among 2,229 patients assigned to the placebo group. Pooled odds ratio (OR) of developing tuberculosis infection was significantly higher with infliximab therapy than with placebo [2.86; 95% confidence interval (CI), 1.09‑7.52]. The OR of tuberculosis infection was 3.93 (95% CI, 0.91‑16.91) in RA, 2.46 (95% CI, 0.38‑15.92) in SpA and 1.66 (95% CI, 0.26‑10.57) in IBD. Rates of tuberculosis infection with infliximab therapy in RA, SpA and IBD were 0.70, 0.22 and 0.52%, respectively. Compared with placebo, infliximab therapy may increase the risk of developing tuberculosis. However, the ORs for the risk of infliximab-associated tuberculosis were not demonstrated to be significant in IBD, RA and SpA; therefore, these findings should be interpreted with caution. The risk of developing tuberculosis demonstrates the importance of the prevention and management of tuberculosis infection with infliximab therapy.
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September-2016
Volume 12 Issue 3

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Spandidos Publications style
Wang Q, Wen Z and Cao Q: Risk of tuberculosis during infliximab therapy for inflammatory bowel disease, rheumatoid arthritis, and spondyloarthropathy: A meta-analysis. Exp Ther Med 12: 1693-1704, 2016
APA
Wang, Q., Wen, Z., & Cao, Q. (2016). Risk of tuberculosis during infliximab therapy for inflammatory bowel disease, rheumatoid arthritis, and spondyloarthropathy: A meta-analysis. Experimental and Therapeutic Medicine, 12, 1693-1704. https://doi.org/10.3892/etm.2016.3548
MLA
Wang, Q., Wen, Z., Cao, Q."Risk of tuberculosis during infliximab therapy for inflammatory bowel disease, rheumatoid arthritis, and spondyloarthropathy: A meta-analysis". Experimental and Therapeutic Medicine 12.3 (2016): 1693-1704.
Chicago
Wang, Q., Wen, Z., Cao, Q."Risk of tuberculosis during infliximab therapy for inflammatory bowel disease, rheumatoid arthritis, and spondyloarthropathy: A meta-analysis". Experimental and Therapeutic Medicine 12, no. 3 (2016): 1693-1704. https://doi.org/10.3892/etm.2016.3548