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Risk of Infections and Cancer in Patients With Rheumatologic Diseases Receiving Interleukin Inhibitors: A Systematic
Jawad Bilal1, Adam Berlinberg2, Irbaz Bin Riaz3
1Division of Rheumatology, Department of Medicine, University of Arizona, Tucson.
JAMA Network Open
|October 19, 2019
Summary
Interleukin (IL) inhibitors increase the risk of serious infections, opportunistic infections, and cancer in patients with rheumatologic diseases. This meta-analysis highlights potential safety concerns associated with IL inhibitor use.
Area of Science:
- Rheumatology
- Immunology
- Oncology
Background:
- The safety profile of interleukin (IL) inhibitors, commonly used for rheumatologic diseases, requires thorough evaluation.
- Existing data on the risks of serious infections, opportunistic infections, and cancer associated with IL inhibitors are not well-established.
Purpose of the Study:
- To systematically assess the risk of serious infections, opportunistic infections, and cancer in patients with rheumatologic diseases treated with IL inhibitors.
- To provide a quantitative analysis of these safety outcomes through meta-analysis.
Main Methods:
- A comprehensive literature search was conducted across multiple databases (Ovid MEDLINE, Embase, Cochrane, Scopus) up to November 30, 2018.
- Randomized, placebo-controlled trials reporting safety data for IL inhibitor therapies in rheumatic diseases were included.
- Fixed-effects meta-analysis was employed to pool odds ratios (ORs) for key safety outcomes.
Main Results:
- The meta-analysis included 74 studies with 29,214 patients.
- Patients receiving IL inhibitors showed a significantly higher risk of serious infections (OR, 1.97), opportunistic infections (OR, 2.35), and cancer (OR, 1.52) compared to placebo.
- The certainty of evidence was high for serious infections and moderate for opportunistic infections and cancer.
Conclusions:
- Interleukin inhibitor therapy is associated with an increased risk of serious infections, opportunistic infections, and cancer in patients with rheumatologic conditions.
- These findings underscore the importance of careful patient monitoring and risk-benefit assessment when prescribing IL inhibitors.
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