Disease-modifying antirheumatic drugs and risk of incident interstitial lung disease among patients with rheumatoid arthritis: A systematic review and meta-analysis
Authors' conclusion
Observational data suggest no increased risk for any DMARD for incident RA-ILD risk, and perhaps a potential protective role of MTX and tofacitinib. However, these studies may be susceptible to bias, and no specific DMARD showed associations with incident RA-ILD in RCTs.
Study context
- Population
- Adults with rheumatoid arthritis (RA); PubMed, Embase, Web of Science and Cochrane Library searched from inception to November 202340 papers
- Participants
- 486,465 adults
- Comparison
- Disease-modifying antirheumatic drugs (DMARDs) of interest vs placebo, no DMARDs, or other DMARDs
- Tofacitinibn = 2,911
- Tumor necrosis factor inhibitor (TNFi)n = 1,451reference
- Outcome
- Incident ILD
Methodological detailsRandomized controlled trials (RCTs), observational studies and post-marketing surveillance studies, Mantel-Haenszel method
- RCTs, observational studies and post-marketing surveillance studies
- Mantel-Haenszel method
Pooled result
As reported in the abstract
Estimate (95% CI)P value
Tofacitinibvs TNFilargest RCT (Oral Surveillance trial)
OR 0.94(0.52–1.69)
P = 0.828MTXvs No MTX7 observational studies
pooled OR 0.49(0.32–0.76)
P < 0.001Tofacitinibvs TNFisingle observational study
OR 0.36(0.15–0.87)
P = 0.024Original publication
Disease-modifying antirheumatic drugs and risk of incident interstitial lung disease among patients with rheumatoid arthritis: A systematic review and meta-analysis. Semin Arthritis Rheum. Published 11 October 2024. doi:10.
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