Rheumatic Patients Taking Interleukin Inhibitors At Risk Of Increased Infection And Cancer
A new meta analytic study by medical researchers from the University of Arizona, Tucson indicate that patients with rheumatic diseases
that are treated with interleukin inhibitors
have increased risk of serious infections, opportunistic infections, and cancer
Dr Jawad Bilal from the University of Arizona, Tucson, co-author of the study told Thailand Medical
News, “These findings can inform shared decision-making when patients and clinicians are contemplating the use of interleukin inhibitors
To investigate these risks, study authors searched various databases for clinical trials evaluating interleukin therapy vs placebo in patients with rheumatic diseases
in which safety data were reported. They identified 74 studies that included 29,214 patients; treatments evaluated in these studies included tocilizumab (18 trials), secukinumab (15 trials), anakinra (8 trials), ixekizumab (6 trials), rilonacept (6 trials), sarilumab (4 trials), sirukumab (4 trials), ustekinumab (4 trials), brodalumab (3 trials), guselkumab (2 trials), clazakizumab (2 trials), canakinumab (1 trial), and olokizumab (1 trial).
Pooled analysis showed that treatment with interleukin inhibitors
was associated with a higher risk of serious infections (infections resulting in hospitalization, use of antibiotics, or death) when compared with placebo (odds ratio [OR] 1.97; 95% CI, 1.58-2.44; P
= 0%; high certainty). Moreover, the risk of opportunistic infection was found to be increased with interleukin inhibitors
vs placebo (OR 2.35; 95% CI, 1.09-5.05; P
= 0%; moderate certainty).
In addition, study data showed an increased risk of cancer
in patients with rheumatic diseases
treated with interleukin inhibitors
(OR 1.52; 95% CI, 1.05-2.19; P
= 11%; moderate certainty). “The findings in our study suggest that the risk of cancer
may be increased with longer [interleukin] inhibitor therapy,” the study authors added.
Based on their findings, the authors concluded that infection risk with interleukin inhibitors
appears to be comparable to what has been observed with other biologic therapies (ie, tumor necrosis factor inhibitors), while real-world data are needed to confirm the potential for increased cancer risk with long-term therapy.
ess, they say that the possibility of increased cancer
risk with long-term IL inhibitor use should be taken into consideration.
Patients currently on these drugs are advised to consult their doctors before making any attempts to stop or switch drugs.
Reference: Risk of Infections and Cancer in Patients With Rheumatologic Diseases Receiving Interleukin Inhibitors: A Systematic Review and Meta-analysis. Bilal J, Berlinberg A, Riaz IB, Faridi W, Bhattacharjee S, Ortega G, Murad MH, Wang Z, Prokop LJ, Alhifany AA, Kwoh CK1. JAMA Netw Open. 2019 Oct 2;2(10):e1913102. doi: 10.1001/jamanetworkopen.2019.13102. https://www.ncbi.nlm.nih.gov/pubmed/31626313