Baghdadi Leena R
Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Psychol Res Behav Manag. 2024 Oct 4;17:3419-3441. doi: 10.2147/PRBM.S482409. eCollection 2024.
Depression is a possible cause of the increased mental health risks associated with rheumatoid arthritis (RA), including depression-related complications. Biological disease-modifying antirheumatic drug (bDMARDs) therapies have emerged as innovative anti-inflammatory drugs with positive effects on mental well-being. Tocilizumab is a bDMARDs commonly used to treat RA and its influence on depression needs to be studied. It targets interleukin-6 (IL-6) receptors, reducing inflammation, which may also alleviate depressive symptoms due to the role of inflammation in the pathophysiology of depression. Thus, its influence on depression needs to be studied. To assess the strength of the association between exposure to tocilizumab and the rate of development of depression in patients with RA and to evaluate tocilizumab as an exposure and depression as an outcome in these patients, a search was conducted in the MEDLINE, PreMEDLINE, Cochrane, and Scopus databases from January 1980 to April 2024. Inclusion criteria were studies that diagnosed RA according to the latest American College of Rheumatology/European League Against Rheumatism guidelines or a rheumatologist and provided information on tocilizumab exposure and diagnosed depression as an outcome. The present meta-analysis was conducted following the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. These studies were assessed for eligibility by the author and an independent assessor. To summarize the findings, the meta-analysis combined the relative risk estimates from each study with raw data counts. Twelve studies in the meta-analysis fulfilled the inclusion criteria. Tocilizumab monotherapy exhibited a promising beneficial effect on the risk of depression, indicated by the decreased risk in RA patients (Relative risk 0.68, 95% CI 0.20, 2.31). Patients with RA on tocilizumab treatment had a lower risk of developing depression compared to those unexposed to tocilizumab treatment. Therefore, future longitudinal studies are needed to confirm the beneficial effect of tocilizumab on depression in the RA population.
抑郁症是类风湿关节炎（RA）相关心理健康风险增加的一个可能原因，包括与抑郁症相关的并发症。生物性改善病情抗风湿药物（bDMARDs）疗法已成为对心理健康有积极影响的创新性抗炎药物。托珠单抗是一种常用于治疗RA的bDMARDs，其对抑郁症的影响有待研究。它作用于白细胞介素-6（IL-6）受体，减轻炎症，由于炎症在抑郁症病理生理学中的作用，这也可能减轻抑郁症状。因此，需要研究其对抑郁症的影响。为了评估托珠单抗暴露与RA患者抑郁症发生率之间关联的强度，并将托珠单抗作为暴露因素、抑郁症作为这些患者的结局进行评估，我们于1980年1月至2024年4月在MEDLINE、PreMEDLINE、Cochrane和Scopus数据库中进行了检索。纳入标准为根据最新的美国风湿病学会/欧洲抗风湿病联盟指南或由风湿病学家诊断为RA的研究，并提供托珠单抗暴露信息以及将抑郁症诊断作为结局的研究。本荟萃分析按照系统评价和荟萃分析的首选报告项目（PRISMA）声明的指南进行。这些研究由作者和一名独立评估者评估其 eligibility。为了总结研究结果，荟萃分析将每项研究的相对风险估计值与原始数据计数相结合。荟萃分析中的12项研究符合纳入标准。托珠单抗单药治疗对抑郁症风险显示出有前景的有益作用，RA患者风险降低表明了这一点（相对风险0.68，95%置信区间0.20，2.31）。与未接受托珠单抗治疗的患者相比，接受托珠单抗治疗的RA患者患抑郁症的风险更低。因此，未来需要进行纵向研究以证实托珠单抗对RA人群抑郁症的有益作用。 （注：原文中“eligibility”未翻译，可能是拼写有误，推测应为“合格性”之类的意思，这里保留英文未翻译。）
