PMID- 30183597
OWN - NLM
STAT- MEDLINE
DCOM- 20190516
LR  - 20190516
IS  - 0392-856X (Print)
IS  - 0392-856X (Linking)
VI  - 37
IP  - 2
DP  - 2019 Mar-Apr
TI  - Tocilizumab and the risk of respiratory adverse events in patients with 
      rheumatoid arthritis: a systematic review and meta-analysis of randomised 
      controlled trials.
PG  - 318-323
AB  - OBJECTIVES: The purpose of this study is to evaluate the relative risk (RR) of 
      respiratory adverse events (AEs) among patients with RA treated with TCZ. 
      METHODS: Databases (PubMed, Embase and Cochrane Library) were searched for 
      randomised controlled trials (RCT) comparing the use of TCZ with placebo (PBO) or 
      active comparator agents in adults with RA published until October 28, 2017. 
      Statistical analyses were conducted to calculate the RR of infectious and 
      non-infectious respiratory AEs and severe AEs (SAEs) using random-effects or 
      fixed-effects models based on the heterogeneity of the included studies. RESULTS: 
      Eight trials were ultimately included. TCZ was associated with an increased risk 
      of infectious respiratory AEs relative to comparator agents (RR 1.53, 95% 
      confidence interval [95% CI] 1.04-2.25) but was not associated with an increased 
      risk of non-infectious respiratory AEs (RR 1.19, 95% CI 0.86-1.64). A subgroup 
      analysis revealed similar results for non-infectious AEs and SAEs in the 
      comparisons of TCZ with MTX and adalimumab (ADA), whereas increased risks of 
      these AEs but not SAEs were observed compared with the PBO. CONCLUSIONS: Our 
      meta-analysis did not reveal an increase in the risk of non-infectious 
      respiratory AEs in adult patients with RA who were treated with TCZ compared with 
      other csDMARDs and bDMARDs in RCTs.
FAU - Geng, Zhe
AU  - Geng Z
AD  - Department of Haematology, Tongji Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology, Wuhan, China.
FAU - Yu, Yikai
AU  - Yu Y
AD  - Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical 
      College, Huazhong University of Science and Technology, Wuhan, China.
FAU - Hu, Shaoxian
AU  - Hu S
AD  - Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical 
      College, Huazhong University of Science and Technology, Wuhan, China.
FAU - Dong, Lingli
AU  - Dong L
AD  - Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical 
      College, Huazhong University of Science and Technology, Wuhan, China.
FAU - Ye, Cong
AU  - Ye C
AD  - Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical 
      College, Huazhong University of Science and Technology, Wuhan, China. 
      yecong2011@163.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20180829
PL  - Italy
TA  - Clin Exp Rheumatol
JT  - Clinical and experimental rheumatology
JID - 8308521
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Antirheumatic Agents)
RN  - FYS6T7F842 (Adalimumab)
RN  - I031V2H011 (tocilizumab)
SB  - IM
MH  - Adalimumab
MH  - Adult
MH  - Antibodies, Monoclonal, Humanized/*adverse effects/therapeutic use
MH  - *Antirheumatic Agents/adverse effects/therapeutic use
MH  - *Arthritis, Rheumatoid/drug therapy
MH  - Humans
MH  - Respiratory Tract Diseases/*chemically induced
EDAT- 2018/09/06 06:00
MHDA- 2019/05/17 06:00
CRDT- 2018/09/06 06:00
PHST- 2018/03/18 00:00 [received]
PHST- 2018/06/20 00:00 [accepted]
PHST- 2018/09/06 06:00 [pubmed]
PHST- 2019/05/17 06:00 [medline]
PHST- 2018/09/06 06:00 [entrez]
AID - 12803 [pii]
PST - ppublish
SO  - Clin Exp Rheumatol. 2019 Mar-Apr;37(2):318-323. Epub 2018 Aug 29.