한국임상약학회지 (Korean Journal of Clinical Pharmacy)

  • 제28권4호
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  • Pages.333-341
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  • 2018
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  • 1226-6051(pISSN)
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  • 2508-786X(eISSN)
한국임상약학회 (Korean College Of Clinical Pharmacy)
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Tumor Necrosis Factor-alpha 저해제가 결핵 발생에 미치는 영향

Effects of Tumor Necrosis Factor-alpha Inhibitors on the Incidence of Tuberculosis

  • 박현진 (서울대학교 약학대학, 종합약학연구소) ;
  • 최보윤 (서울대학교 약학대학, 종합약학연구소) ;
  • 손민지 (서울대학교 약학대학, 종합약학연구소) ;
  • 한나영 (서울대학교 약학대학, 종합약학연구소) ;
  • 김인화 (서울대학교 약학대학, 종합약학연구소) ;
  • 오정미 (서울대학교 약학대학, 종합약학연구소)
  • Park, Hyun Jin (College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University) ;
  • Choi, Bo Yoon (College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University) ;
  • Sohn, Minji (College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University) ;
  • Han, Na Young (College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University) ;
  • Kim, In-Wha (College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University) ;
  • Oh, Jung Mi (College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University)
  • 투고 : 2018.11.19
  • 심사 : 2018.12.11
  • 발행 : 2018.12.29
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초록

Objective: Tumor necrosis factor-alpha (TNF-alpha) inhibitors are used as a treatment in various immune-mediated inflammatory diseases (IMIDs). Tuberculosis (TB) risk is reported in several meta-analyses in patients treated with TNF-alpha inhibitors. The purpose of this study is to collect, review, and evaluate the TB risk in TNF-alpha inhibitors according to IMIDs indications and between soluble-receptor TNF-alpha inhibitor and monoclonal-antibody TNF-alpha inhibitors. Methods: A systematic literature search on systematic reviews and meta-analyses was performed in PubMed, MEDLINE, Cochrane library, and EMBASE. We identified meta-analyses that evaluated TB infection risk of TNF-alpha inhibitors in IMIDs patients. Results: Thirteen meta-analyses including 41 study results were included in this umbrella review. IMIDs patients treated with TNF-alpha inhibitors had an increased risk of TB than control group (placebo with or without standard therapy patients) (relative risk ratio (RR) 2.057, 95% confidence interval (CI) 1.697 to 2.495). Among them, RA patients with TNF-alpha inhibitors had a higher risk of TB than control group (RR 1.847, 95% CI 1.385 to 2.464), and non-RA patients with TNF-alpha inhibitors had an increased risk of TB (RR 2.236, 95% CI 1.284 to 3.894). In subgroup analysis on TB risk between soluble-receptor TNF-alpha inhibitor and monoclonal-antibody TNF-alpha inhibitors in RA patients, the analysis indicated that monoclonal-antibody TNF-alpha inhibitors had higher risk of TB than soluble-receptor TNF-alpha inhibitor (RR 2.880, 95% CI 1.730 to 4.792). Conclusion: This umbrella review confirms that the risk of TB is significantly increased in TNF-alpha inhibitor treated patients compared to control group.

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피인용 문헌

  1. Pathogenetic role of tumor necrosis factor (TNF-α) for the development of peritoneal tuberculosis in an experiment vol.6, pp.5, 2018, https://doi.org/10.29413/abs.2021-6.5.18