抗肿瘤坏死因子治疗炎症性肠病不会促进银屑病的发展：一项荟萃分析。
Antitumor necrosis factor treatment in patients with inflammatory bowel disease does not promote psoriasis development: A meta-analysis.
机构信息
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Seoul National University College of Medicine, Seoul, Republic of Korea.
出版信息
Medicine (Baltimore). 2022 Jul 8;101(27):e29872. doi: 10.1097/MD.0000000000029872.
BACKGROUND
Recent case reports have suggested that anti-tumor necrosis factor (TNF) agents are associated with an increased risk of developing psoriasis in patients with inflammatory bowel disease (IBD).
AIMS
This meta-analysis of published studies aimed to evaluate the association between anti-TNF treatment and psoriasis in patients with IBD.
METHODS
An electronic search for original articles published before April 7, 2022, was performed using PubMed, EMBASE, and the Cochrane Library. Independent reviewers conducted the article screening and data extraction. Psoriasis development between anti-TNF-treated and anti-TNF-naïve patients was compared. Patients with ulcerative colitis and Crohn disease were compared with determine the differences in anti-TNF-induced psoriasis. Also, psoriasis development was compared according to the types of anti-TNF agents. Random-effects model meta-analyses, network meta-analysis, funnel plot asymmetry, Begg rank correlation test, and Egger regression test were performed to generate summary estimates and explore the possibility of publication bias.
RESULTS
We analyzed a total of 10,778 articles searched and 14 articles were selected to analyze. There was no significant difference in psoriasis development between anti-TNF-treated and anti-TNF-naïve patients (relative risk = 1.14; 95% confidence interval = 0.77-1.68). No differences were found for psoriasis development between anti-TNF-treated ulcerative colitis and Crohn disease patients (relative risk = 1.30; 95% confidence interval = 0.87-1.95). No significant difference was reported with respect to psoriasis development according to the types of anti-TNF agents. We found no definitive publication bias in our analyses.
CONCLUSIONS
Anti-TNF treatment did not contribute to the psoriasis development in patients with IBD. Based on our study, anti-TNF agents may be used for IBD treatment without concern for psoriasis development.
背景
最近的病例报告表明，肿瘤坏死因子（TNF）拮抗剂与炎症性肠病（IBD）患者发生银屑病的风险增加有关。
目的
本荟萃分析旨在评估 TNF 拮抗剂治疗与 IBD 患者银屑病之间的相关性。
方法
检索了 PubMed、EMBASE 和 Cochrane 图书馆在 2022 年 4 月 7 日前发表的原始文章，由独立的审查员进行文章筛选和数据提取。比较 TNF 拮抗剂治疗与 TNF 拮抗剂未治疗患者之间的银屑病发展情况。比较溃疡性结肠炎和克罗恩病患者之间 TNF 拮抗剂诱导的银屑病的差异。还根据 TNF 拮抗剂的类型比较了银屑病的发展情况。使用随机效应模型荟萃分析、网络荟萃分析、漏斗图不对称性、Begg 等级相关检验和 Egger 回归检验来生成汇总估计值，并探讨发表偏倚的可能性。
结果
共分析了检索到的 10778 篇文章，选择了 14 篇文章进行分析。TNF 拮抗剂治疗与 TNF 拮抗剂未治疗患者的银屑病发展情况无显著差异（相对风险 = 1.14；95%置信区间 = 0.77-1.68）。TNF 拮抗剂治疗溃疡性结肠炎和克罗恩病患者的银屑病发展情况无差异（相对风险 = 1.30；95%置信区间 = 0.87-1.95）。根据 TNF 拮抗剂的类型，银屑病的发展情况无显著差异。我们的分析未发现明确的发表偏倚。
结论
TNF 拮抗剂治疗不会导致 IBD 患者发生银屑病。根据我们的研究，TNF 拮抗剂可用于 IBD 治疗，而不必担心银屑病的发生。
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