Evidence map›Paper›PMID 39639969›Full record

ReviewNew microbes and new infections2024

Risk of tuberculosis disease in patients receiving TNF-α antagonist therapy: A meta-analysis of randomized controlled trials.

Fatemeh Khelghati, Mohammad Rahmanian, Elaheh Eghbal, Zahra Sadat Seghatoleslami, Mehdi Goudarzi, Aliasghar Keramatinia, Catherine Wm Ong, Delia Goletti, Lia D'Ambrosio, Rosella Centis and 2 more

Abstract readReview
In one paragraph

Review in New microbes and new infections, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. HowVaccines · 2026
    Review
  3. Article
  4. Review
  5. Observational
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Fatemeh KhelghatiDepartment of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mohammad RahmanianDepartment of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Elaheh EghbalInfectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Zahra Sadat SeghatoleslamiDepartment of Infectious Diseases, Islamic Azad University, Tehran Medical Branch, Tehran, Iran.
Mehdi GoudarziDepartment of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Aliasghar KeramatiniaDepartment of Community Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Catherine Wm OngDivision of Infectious Diseases, Department of Medicine, National University Hospital, Singapore, Singapore.
Delia GolettiTranslational Research Unit, Department of Epidemiology and Preclinical Research National Institute for Infectious Diseases L. Spallanzani-IRCCS, Roma, Italy.
Lia D'AmbrosioPublic Health Consulting Group, Lugano, Switzerland.
Rosella CentisServizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy.
Mohammad Javad NasiriDepartment of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Giovanni Battista MiglioriServizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Tuberculosis (TB) risk associated with tumor necrosis factor-alpha (TNF-α) antagonist therapy in patients with autoimmune diseases is a significant concern. This study aims to evaluate the risk of TB disease associated with TNF-α antagonist therapy. Methods: An extensive search of PubMed/MEDLINE, EMBASE, and the Cochrane CENTRAL databases was conducted to identify randomized controlled trials (RCTs) assessing TB disease risk in patients receiving TNF-α antagonist therapy available until November 1, 2024. The pooled statistic used was the weighted odds ratio (OR) and a corresponding 95 % confidence interval (CI). Statistical analysis was performed using Comprehensive Meta-Analysis software, version 3.0 (Biostat Inc., Englewood, NJ, USA). Results: Fifty-six RCTs, totaling 22,212 adult patients, met the specified eligibility criteria. Pooled analysis revealed an increased risk of TB disease associated with TNF-α antagonist therapy (OR 1.52, 95 % CI 1.03-2.26, p = 0.03). Subgroup analyses indicated a higher risk in patients with rheumatoid arthritis (RA) (OR 2.25, 95 % CI 1.13-4.45, p = 0.02), while no significant associations were found in patients with ankylosing spondylitis (AS) or psoriasis (Ps). Analyses by specific TNF-α antagonist drugs did not yield significant associations with risk of TB disease. Conclusion: Our study highlights an increased risk of TB disease associated with TNF-α antagonist therapy, particularly in patients with RA. However, the absence of significant associations in AS or Ps patients suggests disease-specific variations in risk of TB disease. Further research is needed to elucidate the long-term safety profile of TNF-α antagonist drugs and their associations with risk of TB disease in different patient populations.

Indexed as

AdalimumabAutoimmune diseasesCertolizumab pegolEtanerceptGolimumabInfliximabRheumatoid arthritisTNF-α antagonist therapyTuberculosis

Identifiers

PMID39639969
PMCPMC11617757

What OpenQuestion holds

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Registered trials

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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.