Baseline adiponectin and leptin levels in predicting an increased risk of disease activity in rheumatoid arthritis: A meta-analysis and systematic review

Background: Natalizumab (NTZ) is sometimes discontinued in patients with multiple sclerosis, mainly due to concerns about the risk of progressive multifocal leukoencephalopathy. However, NTZ interruption may result in recrudescence of disease activity. Objective: The objective of this study was to summarize the available evidence about NTZ discontinuation and to identify which patients will experience post-NTZ disease reactivation through meta-analysis of existing literature data. Methods: PubMed was searched for articles reporting the effects of NTZ withdrawal in adult patients (⩾18 years) with relapsing–remitting multiple sclerosis (RRMS). Definition of disease activity following NTZ discontinuation, proportion of patients who experienced post-NTZ disease reactivation, and timing to NTZ discontinuation to disease reactivation were systematically reviewed. A generic inverse variance with random effect was used to calculate the weighted effect of patients’ clinical characteristics on the risk of post-NTZ disease reactivation, defined as the occurrence of at least one relapse. Results: The original search identified 205 publications. Thirty-five articles were included in the systematic review. We found a high level of heterogeneity across studies in terms of sample size (10 to 1866 patients), baseline patient characteristics, follow up (1–24 months), outcome measures (clinical and/or radiological), and definition of post-NTZ disease reactivation or rebound. Clinical relapses were observed in 9–80% of patients and peaked at 4–7 months, whereas radiological disease activity was observed in 7–87% of patients starting at 6 weeks following NTZ discontinuation. The meta-analysis of six articles, yielding a total of 1183 patients, revealed that younger age, higher number of relapses and gadolinium-enhanced lesions before treatment start, and fewer NTZ infusions were associated with increased risk for post-NTZ disease reactivation ( p ⩽ 0.05). Conclusions: Results from the present review and meta-analysis can help to profile patients who are at greater risk of post-NTZ disease reactivation. However, potential reporting bias and variability in selected studies should be taken into account when interpreting our data.

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Medication adherence has an impact on disease activity in rheumatoid arthritis: a systematic review and meta-analysis

Patient Preference and Adherence ◽

10.2147/ppa.s140457 ◽

2017 ◽

Vol Volume 11 ◽

pp. 1343-1356 ◽

Cited By ~ 15

Author(s):

Lin Li ◽

Yafei Cui ◽

Rulan Yin ◽

Shengnan Chen ◽

Qian Zhao ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Systematic Review ◽

Medication Adherence ◽

Disease Activity ◽

Meta Analysis

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Reduction of biologics in rheumatoid arthritis treatment

Revista dos Trabalhos de Iniciação Científica da UNICAMP ◽

10.20396/revpibic262018833 ◽

2019 ◽

Author(s):

Leticia Breda e Vasconcelos ◽

Tais Freire Galvao

Keyword(s):

Rheumatoid Arthritis ◽

Systematic Review ◽

Relative Risk ◽

Disease Activity ◽

Clinical Outcomes ◽

Standard Dose ◽

Meta Analysis ◽

Biological Drugs ◽

Low Disease Activity ◽

Standardized Mean Difference

This systematic review assesses the effectiveness and safety of reducing the dose of biological drugs in patients with rheumatoid arthritis at low disease activity, compared to standard dose treatment. Clinical outcomes data were collected and summarized in meta-analysis of standardized mean difference or relative risk. Most outcomes were non-significant.

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Patients with rheumatoid arthritis have an increased risk of incident chronic kidney disease: a systematic review and meta-analysis of cohort studies

International Urology and Nephrology ◽

10.1007/s11255-019-02346-4 ◽

2019 ◽

Vol 52 (1) ◽

pp. 147-154 ◽

Cited By ~ 2

Author(s):

Sukit Raksasuk ◽

Patompong Ungprasert

Keyword(s):

Rheumatoid Arthritis ◽

Systematic Review ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Cohort Studies ◽

Meta Analysis ◽

Increased Risk ◽

Incident Chronic Kidney Disease

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The influence of disease activity on pregnancy outcomes in women with inflammatory bowel disease: A systematic review and meta-analysis

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjaa225 ◽

2020 ◽

Author(s):

Min-A Kim ◽

Young-Han Kim ◽

Jaeyoung Chun ◽

Hye Sun Lee ◽

Soo Jung Park ◽

...

Keyword(s):

Systematic Review ◽

Preterm Birth ◽

Disease Activity ◽

Spontaneous Abortion ◽

Pregnancy Outcomes ◽

Meta Analysis ◽

Cochrane Library ◽

Increased Risk ◽

Adverse Pregnancy ◽

The Impact

Abstract Background & Aims Robust evidence regarding the impact of disease activity on pregnancy outcomes in women with IBD is crucial for both clinicians and patients in preparing a birth plan. We sought to perform a systematic review and meta-analysis to assess the pooled influences of disease activity on pregnancy outcomes in women with IBD. Methods We searched MEDLINE, EMBASE, and COCHRANE library to identify articles comparing pregnancy outcomes between active and inactive IBD at the time of conception or during pregnancy. A meta-analysis was performed using a random-effects model to pool estimates and report odds ratios (ORs). Results A total of 28 studies were identified as eligible for the meta-analysis. In women with active IBD, the pooled ORs for low birth weight (LBW), preterm birth, small for gestational age (SGA), spontaneous abortion, and stillbirths were 3.81 (95% confidence interval [CI] 1.81-8.02), 2.42 (95% CI 1.74-3.35), 1.48 (95% CI 1.19-1.85), 1.87 (95% CI 1.17-3.0), and 2.27 (95% CI 1.03-5.04) compared to women with inactive IBD, respectively. In the subgroup analysis based on disease type, women with active ulcerative colitis had an increased risk of LBW, preterm birth, and spontaneous abortion. Women with active Crohn’s disease had a higher risk of preterm birth, SGA, and spontaneous abortion. Conclusions Active IBD during the periconception period and pregnancy is associated with increased risk of adverse pregnancy outcomes. Our data suggest that pregnancy should be planned when the disease is quiescent, and continuous disease control is important even during pregnancy.

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