{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:04:39Z","timestamp":1790705079871,"version":"4.1.0"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T00:00:00Z","timestamp":1635724800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Adalimumab, golimumab, infliximab, certolizumab, and etanercept are five anti-tumor necrosis factor (anti-TNF) medicines that have been approved for use in rheumatology. Apart from their well-established therapeutic usefulness, -it is unclear to what extent -they are linked to an increased risk of various side effects. The present meta-analysis was carried out to assess the risk of infection and other side effects after anti-TNF- \u03b1 for the treatment of rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> We searched PubMed, Cinahl (<jats:italic>via<\/jats:italic> Ebsco), Scopus, and Web of Sciences databases for trials comparing anti-TNF medications to placebo or no therapy in adult patients with rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis from August 2006 to August 2020. A total of 23 articles were used for meta-analysis. The Cochrane Collaboration\u2019s risk of bias tool was used to assess the methodological quality of the included studies. In addition, a random-effects model was used to calculate the pooled odds ratio, and Forest plots were constructed to determine the risk of infections and cancer following the use of anti-TNF treatment.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Treatment with anti-TNF\u03b1 agents resulted in an increase in the risk of serious infections (OR: 1.72, 95% CI: 1.56\u20131.90, <jats:italic>p<\/jats:italic> &amp;lt; 0.00001) and an increase in cancer risk (OR: 1.36, 95% CI: 1.20\u20131.53, <jats:italic>p<\/jats:italic> &amp;lt; 0.00001) whereas the risk of developing tuberculosis was not significantly different with anti-TNF\u03b1 agents versus those without treatment with anti-TNF\u03b1 agents (OR: 2.55, 95% CI: 0.40\u201316.23, <jats:italic>p<\/jats:italic> = 0.32) although the number of studies is limited to make a definitive conclusion. The risk of bias of the included studies was unclear to high across most domains, and there was evidence of publication bias for most outcomes.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> The present meta-analysis suggests an increased risk of infectious adverse events, including overall adverse events and cancer following anti-TNF\u03b1 treatment, whereas the risk of tuberculosis was not significantly different. Although anti-TNF agents have shown promise to treat inflammatory conditions, their use should be balanced by the risk-benefit ratio as suggested by the meta-analysis.<\/jats:p>","DOI":"10.3389\/fphar.2021.746396","type":"journal-article","created":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T06:16:16Z","timestamp":1635747376000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":80,"title":["Risk of Adverse Events After Anti-TNF Treatment for Inflammatory Rheumatological Disease. 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