Prognostic factors for liver, blood and kidney adverse events from glucocorticoid sparing immune-suppressing drugs in immune-mediated inflammatory diseases: a prognostic systematic review
Authors' conclusion
Prognostic factors for target-organ damage were identified which may be further investigated for their potential role in targeted (risk-stratified) monitoring.
Study context
- Population
- People receiving glucocorticoid sparing immune-suppressing drugs for IMIDs56 studies from 58 papers
- Outcome
- Prognostic factors associated with liver, blood or kidney adverse events
Methodological detailsmodified CHARMS-PF checklist, QUIPS risk of bias, GRADE-informed quality of evidence, Excluded: studies published before 1995, with <200 participants, or not in English
- Modified CHARMS-PF checklist
- QUIPS risk of bias
- GRADE-informed quality of evidence
- Excluded: studies published before 1995, with <200 participants, or not in English
Pooled result
As reported in the abstract
High-quality evidence of prognostic factors
- Elevated liver enzymes (6 studies): prognostic factor for hepatotoxicity with MTX
- Folate non-supplementation (3 studies): prognostic factor for hepatotoxicity with MTX
- Mercaptopurine (vs AZA) (3 studies): prognostic factor for hepatotoxicity with thiopurines
- Mercaptopurine (vs AZA) (3 studies): prognostic factor for cytopenia with thiopurines
- Poor-metaboliser status (4 studies): prognostic factor for cytopenia with thiopurines
- Baseline elevated liver enzymes (3 studies): prognostic factor for hepatotoxicity with anti-TNF
Further pooled results
Moderate and low quality evidence
- Several other demographic, lifestyle, comorbidity, baseline bloods/serologic or treatment-related prognostic factors identified
Original publication
Prognostic factors for liver, blood and kidney adverse events from glucocorticoid sparing immune-suppressing drugs in immune-mediated inflammatory diseases: a prognostic systematic review. RMD Open. Published 10 January 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →