PMID- 26663412
OWN - NLM
STAT- MEDLINE
DCOM- 20170719
LR  - 20220409
IS  - 2151-4658 (Electronic)
IS  - 2151-464X (Linking)
VI  - 68
IP  - 8
DP  - 2016 Aug
TI  - Comparative Risk of Harm Associated With the Use of Targeted Immunomodulators: A 
      Systematic Review.
PG  - 1078-88
LID - 10.1002/acr.22815 [doi]
AB  - OBJECTIVE: To systematically compare the risk of adverse events (AEs) for 13 
      targeted immunomodulators (TIMs) indicated for ankylosing spondylitis (AS), 
      inflammatory bowel diseases, juvenile idiopathic arthritis, plaque psoriasis, 
      psoriatic arthritis (PsA), or rheumatoid arthritis (RA). METHODS: We searched 
      electronic databases through July 2015 to retrieve randomized controlled trials 
      (RCTs) and observational studies comparing AEs between 2 or more TIMs 
      head-to-head. We reported on the following outcomes: number of AEs, 
      discontinuation due to AEs, serious AEs, mortality, serious infections, 
      tuberculosis, herpes zoster, and malignancies. We qualitatively synthesized the 
      literature and conducted random-effects meta-analyses if 3 or more studies 
      provided data for an outcome. RESULTS: Ten head-to-head RCTs and 51 observational 
      studies were included in this systematic review. A majority of the studies (70%) 
      were conducted in RA patients. Risk of treatment discontinuation due to AEs was 
      higher with infliximab than with adalimumab or etanercept in RA, PsA, and AS. A 
      higher risk for serious infections was noted with infliximab than with abatacept, 
      adalimumab, or etanercept in RA. Risk for treatment discontinuation due to AEs, 
      serious infections, and tuberculosis was lower with etanercept than with 
      adalimumab in RA. Limited evidence suggested no comparative differences in risk 
      for mortality, malignancies, and herpes zoster for adalimumab, etanercept, and 
      infliximab in RA. CONCLUSION: Important differences were noted in the safety 
      profile of TIMs in RA, generally favoring abatacept, adalimumab, and etanercept 
      over infliximab. Head-to-head comparative evidence for other TIMs and non-RA 
      populations was insufficient to draw conclusions for most of the safety outcomes.
CI  - (c) 2016, American College of Rheumatology.
FAU - Desai, Rishi J
AU  - Desai RJ
AD  - Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
FAU - Thaler, Kylie J
AU  - Thaler KJ
AD  - Danube University, Krems, Austria.
FAU - Mahlknecht, Peter
AU  - Mahlknecht P
AD  - Danube University, Krems, Austria.
FAU - Gartlehner, Gerald
AU  - Gartlehner G
AD  - Danube University, Krems, Austria, and RTI International, Research Triangle Park, 
      North Carolina.
FAU - McDonagh, Marian S
AU  - McDonagh MS
AD  - Pacific Northwest Evidence-Based Practice Center, Oregon Health & Science 
      University, Portland, Oregon.
FAU - Mesgarpour, Bita
AU  - Mesgarpour B
AD  - Digestive Diseases Research Institute, Tehran University of Medical Sciences, 
      Tehran, Iran.
FAU - Mazinanian, Alireza
AU  - Mazinanian A
AD  - Danube University, Krems, Austria.
FAU - Glechner, Anna
AU  - Glechner A
AD  - Danube University, Krems, Austria.
FAU - Gopalakrishnan, Chandrasekar
AU  - Gopalakrishnan C
AD  - Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
FAU - Hansen, Richard A
AU  - Hansen RA
AD  - Harrison School of Pharmacy, Auburn University, Auburn, Alabama.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Review
PT  - Systematic Review
PL  - United States
TA  - Arthritis Care Res (Hoboken)
JT  - Arthritis care & research
JID - 101518086
RN  - 0 (Immunologic Factors)
SB  - IM
MH  - Arthritis, Juvenile/drug therapy
MH  - Arthritis, Psoriatic/drug therapy
MH  - Arthritis, Rheumatoid/drug therapy
MH  - Humans
MH  - Immune System Diseases/*drug therapy
MH  - Immunologic Factors/*adverse effects
MH  - Inflammatory Bowel Diseases/drug therapy
MH  - Observational Studies as Topic
MH  - Psoriasis/drug therapy
MH  - Randomized Controlled Trials as Topic
MH  - Spondylitis, Ankylosing/drug therapy
EDAT- 2015/12/15 06:00
MHDA- 2017/07/20 06:00
CRDT- 2015/12/15 06:00
PHST- 2015/03/27 00:00 [received]
PHST- 2015/12/07 00:00 [revised]
PHST- 2015/12/08 00:00 [accepted]
PHST- 2015/12/15 06:00 [entrez]
PHST- 2015/12/15 06:00 [pubmed]
PHST- 2017/07/20 06:00 [medline]
AID - 10.1002/acr.22815 [doi]
PST - ppublish
SO  - Arthritis Care Res (Hoboken). 2016 Aug;68(8):1078-88. doi: 10.1002/acr.22815.