TY  - JOUR
A1  -  Galajda Noémi Ágnes
A1  -  Meznerics Fanni Adél
A1  -  Mátrai Péter
A1  -  Fehérvári Péter
A1  -  Lengyel Anna Sára
A1  -  Kolonics Mária Veronika
A1  -  Sipos Z.
A1  -  Kemény Lajos Vince
A1  -  Csupor Dezs?
A1  -  Hegyi Péter
A1  -  Bánvölgyi András
A1  -  Holló Péter
EP  - 1088
SN  - 0926-9959
SP  - 1070
JF  - JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY
TI  - Reducing cardiovascular risk in immune?mediated inflammatory diseases: Tumour necrosis factor inhibitors compared to conventional therapies?A systematic review and meta?analysis
ID  - publicatio33887
Y1  - 2024///
IS  - 6
AV  - public
VL  - 38
UR  - https://doi.org/10.1111/jdv.19900
N2  - Immune?mediated inflammatory disease (IMID) patients including psoriasis, inflammatory arthritides and bowel diseases have a higher risk of developing cardiovascular (CV) diseases compared to the general population. The increased CV risk may be promoted by tumour necrosis factor (TNF)???mediated immunological processes, which are present both in the pathomechanism of IMIDs and atherosclerosis. Our objective was to comprehensively investigate the effect of TNF inhibitors (TNFi) on CV risk compared with conventional therapies in IMIDs. The systematic literature search was conducted in three databases (MEDLINE, EMBASE, Cochrane Library) on 14 November 2022. Randomized controlled trials, cohort and case?control studies were eligible for inclusion. Outcomes consisted of the incidence of CV events, with major adverse cardiovascular events (MACE) as a main endpoint. A random?effects meta?analysis was performed by pooling fully adjusted multivariate hazard ratios (HR) and incidence rate ratios (IRR) with a 95% confidence interval (CI) comparing TNFis with conventional systemic non?biologicals (CSNBs). Of a total of 8724 search results, 56 studies were included overall, of which 29 articles were eligible for the meta?analysis, and 27 were involved in the systematic review. Including all IMIDs, the TNFi group showed a significantly reduced risk of MACE compared with the CSNB group (HR = 0.74, 95% confidence interval (CI) 0.58?0.95, p  = 0.025; IRR = 0.77, 95% CI 0.67?0.88, p  < 0.001). Subgroup analysis of Pso, PsA patients by pooling IRRs also confirmed the significantly decreased risk of MACE in TNFi?treated patients compared with CSNB groups (IRR = 0.79, 95% CI 0.64?0.98). The observational nature of most included studies leading to high heterogeneity represents a limitation. Based on the results, TNFis may reduce the risk of CV events compared to CSNBs. Therefore, earlier use of TNFis compared to conventional systemic agents in the therapeutic sequence may benefit CV risk in IMID patients.
ER  -