SynthesisJournal of the American Academy of Dermatology2011
The risk of infection and malignancy with tumor necrosis factor antagonists in adults with psoriatic disease: a systematic review and meta-analysis of randomized controlled trials.
Synthesis in Journal of the American Academy of Dermatology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
70 citing papers in PubMed, 7 syntheses or guidelines pooled it, 219 citations in OpenAlex.
- Tumor Necrosis Factor-Alpha Inhibitor Use and Malignancy Risk: A Systematic Review and Patient Level Meta-Analysis.Cancers · 2025Pooled it
- Risk of Infections and Cancer in Patients With Rheumatologic Diseases Receiving Interleukin Inhibitors: A Systematic Review and Meta-analysis.JAMA network open · 2019Pooled it
- Risk of Serious Infections in Patients with Psoriasis on Biologic Therapies: A Systematic Review and Meta-Analysis.The Journal of investigative dermatology · 2016Pooled it
- Malignancy risk of anti-tumor necrosis factor alpha blockers: an overview of systematic reviews and meta-analyses.Clinical rheumatology · 2016Pooled it
- Potential increased risk of cancer from commonly used medications: an umbrella review of meta-analyses.Annals of oncology : official journal of the European Society for Medical Oncology · 2014Pooled it
- Adalimumab: long-term safety in 23 458 patients from global clinical trials in rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, psoriatic arthritis, psoriasis and Crohn's disease.Annals of the rheumatic diseases · 2013Pooled it
- Pooled it
- Long-term risk of de novo malignancy with tumor necrosis factor alpha (TNF) inhibitor immunosuppression: a multicenter, retrospective cohort study.Journal of inflammation (London, England) · 2025Article
- Immunosuppressants/Immunomodulators and Malignancy.Journal of clinical medicine · 2025Review
- Review
- The Intersection of Psoriasis and Neoplasia: Risk Factors, Therapeutic Approaches, and Management Strategies.Cancers · 2024Review
- Risk of Cutaneous T Cell Lymphoma with Psoriasis Biologic Therapies.Dermatology and therapy · 2024Review
- Review
- Biologic and Small-Molecule Therapies for Moderate-to-Severe Psoriasis: Focus on Psoriasis Comorbidities.BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy · 2023Review
- Advancing Biologic Therapy for Refractory Autoimmune Hepatitis.Digestive diseases and sciences · 2022Review
- Long-term safety of risankizumab from 17 clinical trials in patients with moderate-to-severe plaque psoriasis.The British journal of dermatology · 2022Article
- Psoriatic Arthritis: The Influence of Co-morbidities on Drug Choice.Rheumatology and therapy · 2022Review
- COVID-19 and immune-mediated inflammatory diseases: effect of disease and treatment on COVID-19 outcomes and vaccine responses.The Lancet. Rheumatology · 2021Review
- Vaccine considerations for adult dermatology patients on immunosuppressive and immunomodulatory therapies: a clinical review.Dermatology online journal · 2021Review
- Hypersensitivity reactions to monoclonal antibodies: Classification and treatment approach (Review).Experimental and therapeutic medicine · 2021Review
10 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThere is a need to better understand the safety of tumor necrosis factor (TNF) inhibitors in patients with psoriatic disease in whom TNF inhibitors are frequently used as monotherapy.
objectiveWe sought to examine the risks of infection and malignancy with the use of TNF antagonists in adult patients with psoriatic disease.
methodsWe conducted a systematic search for trials of TNF antagonists for adults with plaque psoriasis and psoriatic arthritis. We included randomized, placebo-controlled trials of etanercept, infliximab, adalimumab, golimumab, and certolizumab for the treatment of plaque psoriasis and psoriatic arthritis. Twenty of 820 identified studies with a total of 6810 patients were included. Results were calculated using fixed effects models and reported as pooled odds ratios.
resultsOdds ratios for overall infection and serious infection over a mean of 17.8 weeks were 1.18 (95% confidence interval [CI] 1.05-1.33) and 0.70 (95% CI 0.40-1.21), respectively. When adjusting for patient-years, the incidence rate ratio for overall infection was 1.01 (95% CI 0.92-1.11). The odds ratio for malignancy was 1.48 (95% CI 0.71-3.09) and 1.26 (95% CI 0.39-4.15) when nonmelanoma skin cancer was excluded. LIMITATIONS: Short duration of follow-up and rarity of malignancies and serious infections are limitations.
conclusionsThere is a small increased risk of overall infection with the short-term use of TNF antagonists for psoriasis that may be attributable to differences in follow-up time between treatment and placebo groups. There was no evidence of an increased risk of serious infection and a statistically significant increased risk in cancer was not observed with short-term use of TNF inhibitors.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.