Spondyloarthritis & psoriatic arthritis
Incidence of infections in patients with psoriatic arthritis and axial spondyloarthritis treated with biological or targeted disease-modifying agents: a systematic review and meta-analysis of randomised controlled trials, open-label studies and observational studies
Authors' conclusion
Serious infections were rare events in RCTs and real-life studies. Non-serious infections were common adverse events, mainly in RCTs.
Study context
- Population
- Patients with PsA or axial spondyloarthritis (axSpA) treated with TNFi, IL-17i, JAKi, IL-23 or IL-12/23i, phosphodiesterase 4-inhibitors or CTLA4-Ig
- Participants
- 23,333 vs 11,457
- Comparison
- PsA vs axSpA
- PsAn = 23,333
- axSpAn = 11,457
- Outcome
- Incidence rate of serious infections (life-threatening, requiring intravenous antibiotics and/or hospitalisation)
Methodological detailsrandom-effect model
- Random-effect model
Pooled result
As reported in the abstract
Serious infections per 100 PY
- Overall serious infections per 100 patient-years (PY)
- 1.09 (95% CI 0.85 to 1.35)
Further pooled results
Serious infections by study type
- Randomised controlled trials (RCTs), per 100 PY
- 0.77 (95% CI 0.41 to 1.20)
- Observational studies, per 100 PY
- 1.68 (95% CI 1.03 to 2.47)
- Incidence rates (IR) lower in RCTs than observational studies
Serious infections in PsA with IL-12/23i (lowest IR)
- IL-12/23i, per 100 PY
- 0.29 (95% CI 0.00 to 1.03)
Non-serious infections (7257 PsA and 5638 axSpA patients)
- Overall, per 100 PY
- 53.0 (95% CI 43.47 to 63.55)
- RCTs, per 100 PY
- 69.95 (95% CI 61.59 to 78.84)
- Observational studies, per 100 PY
- 15.37 (95% CI 5.11 to 30.97)
Original publication
Incidence of infections in patients with psoriatic arthritis and axial spondyloarthritis treated with biological or targeted disease-modifying agents: a systematic review and meta-analysis of randomised controlled trials, open-label studies and observational studies. RMD Open. Published 15 September 2023. doi:10.
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