Risk of Active Tuberculosis During Anti-TNF-α Inhibitor Use to Treat Rheumatoid Arthritis: A Meta-Analysis of Randomized Controlled Trials

REVIEW
Hanxin Wu, Li Peng, Weijie Ma, Liangyu Zhu, Xinya Wu, Li Gao, Lei Zhong, Jieqin Song, Bingxue Li, Xun Huang, Rui Yang, Fukai Bao, Aihua Liu

 
For citation: Wu H, Peng L, Ma W, Zhu L, Wu X, Gao L, Zhong L, Song J, Li B, Huang X, Yang R, Bao F, Liu A. Risk of Active Tuberculosis During Anti-TNF-α Inhibitor Use to Treat Rheumatoid Arthritis: A Meta-Analysis of Randomized Controlled Trials. International Journal of Biomedicine. 2024;14(3):371-378. doi:10.21103/Article14(3)_RA1
 
Originally published September 6, 2024

Abstract: 

Background: Given the wide application of TNF-α inhibitors for the treatment of rheumatoid arthritis (RA), more active tuberculosis cases have been reported in patients with RA. This meta-analysis was performed to evaluate the risk of active tuberculosis (TB) in RA patients undergoing treatment with TNF-α inhibitors.
Methods and Results: Thirty randomized controlled trials (RCTs), comprising 18,640 patients, were included in the meta-analysis after searching PubMed, EMBASE, and Web of Science databases. Overall, there was a higher risk of active TB in patients with RA undergoing treatment with TNF-α inhibitors than in the control group (Peto OR, 2.57; 95%CI, 1.42-4.66; P=0.002).
Conclusion: Our meta-analysis showed that RA patients treated with TNF-α inhibitors had a higher risk of developing active TB. Tuberculosis screening should be performed before and during the use of TNF-α inhibitors in these patients.

Keywords: 
rheumatoid arthritis • tuberculosis • TNF-α inhibitor • meta-analysis
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Received June 15, 2024.
Accepted August 26, 2024.
©2024 International Medical Research and Development Corporation.