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dc.contributor.authorTruong, Steven L
dc.contributor.authorChin, Jasmine
dc.contributor.authorLiew, David FL
dc.contributor.authorZahir, Syeda Farah
dc.contributor.authorRyan, Elizabeth G
dc.contributor.authorRubel, Diana
dc.contributor.authorRadford-Smith, Graham
dc.contributor.authorRobinson, Philip C
dc.date.accessioned2021-09-27T01:12:34Z
dc.date.available2021-09-27T01:12:34Z
dc.date.issued2021
dc.identifier.issn2198-6576en_US
dc.identifier.doi10.1007/s40744-021-00360-6en_US
dc.identifier.urihttp://hdl.handle.net/10072/408371
dc.description.abstractIntroduction: The aim of this work is to perform a systematic review and meta-analysis of anti-tumor necrosis factor (anti-TNF) and anti-interleukin-17 (anti-IL-17) trials for spondyloarthritis, psoriatic arthritis, and psoriasis comparing rates of inflammatory bowel disease (IBD) events compared to placebo. Methods: MEDLINE, EMBASE, and The Cochrane Library were searched for double-blind, randomized placebo-controlled anti-TNF and anti-IL-17 trials of included diseases. Inflammatory bowel disease events from the RCT period were pooled and meta-analyzed using statistical methods suitable for low-event-rate meta-analysis (Peto’s, Mantel–Haenszel, hypergeometric-normal model, and Shuster-Guo-Skyler). When observed data were insufficient, we performed an exploratory sensitivity analysis to compare methods. Results: We identified 9551 original papers, and included 96 publications: 65 anti-TNF and 31 anti-IL-17 trials, containing 21 new and 12 flare IBD events in 28,209 participants. New IBD on anti-IL-17 occurred 0.23/100 patient-years (PY) in psoriasis, 0.61/100 PY in PsA and 1.63/100 PY in spondyloarthritis, rates similar to observational cohorts, and less commonly on anti-TNF (0/100 PY, 0/100 PY, 0.32/100 PY, respectively). No evidence of difference between groups was found, with wide CI from many pooled counts of zero, especially in placebo arms. Conclusions: IBD events were rare, occurring at rates similar to biologic-naive groups. We could not find statistically significant differences in risk of new or recurrent IBD between treatment and control groups using selected meta-analytical methods for low event rate scenarios. Meta-analyses of this topic require more IBD events, ideally without pooling heterogeneous groups. Larger, thoroughly reported trials with systematic and detailed safety reporting are required to improve risk estimation and to make accurate inferences.en_US
dc.description.peerreviewedYesen_US
dc.languageEnglishen_US
dc.publisherSpringeren_US
dc.relation.ispartofjournalRheumatology and Therapyen_US
dc.subject.fieldofresearchRheumatology and arthritisen_US
dc.subject.fieldofresearchcode320223en_US
dc.subject.keywordsScience & Technologyen_US
dc.subject.keywordsLife Sciences & Biomedicineen_US
dc.subject.keywordsInflammatory bowel diseaseen_US
dc.subject.keywordsAnti-interleukin-17en_US
dc.titleSystematic Review and Meta-Analysis of Inflammatory Bowel Disease Adverse Events with Anti-Interleukin 17A Agents and Tumor Necrosis Factor Inhibitors in Rheumatic Disease and Skin Psoriasisen_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Articlesen_US
dcterms.bibliographicCitationTruong, SL; Chin, J; Liew, DFL; Zahir, SF; Ryan, EG; Rubel, D; Radford-Smith, G; Robinson, PC, Systematic Review and Meta-Analysis of Inflammatory Bowel Disease Adverse Events with Anti-Interleukin 17A Agents and Tumor Necrosis Factor Inhibitors in Rheumatic Disease and Skin Psoriasis, Rheumatology and Therapy, 2021en_US
dcterms.dateAccepted2021-08-11
dcterms.licensehttps://creativecommons.org/licenses/by/4.0/en_US
dc.date.updated2021-09-26T23:53:20Z
dc.description.versionVersion of Record (VoR)en_US
gro.description.notepublicThis publication has been entered in Griffith Research Online as an advanced online version.en_US
gro.rights.copyright© The Author(s) 2021. This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.en_US
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gro.griffith.authorTruong, Steven


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