{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T17:40:59Z","timestamp":1788716459136,"version":"build-2803163510"},"reference-count":41,"publisher":"The Journal of Rheumatology","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>Tumor necrosis factor-\u03b1 (TNF-\u03b1) antagonists have significantly improved treatment results in rheumatoid arthritis (RA), but have also increased the risk of tuberculosis (TB). Etanercept (ETN), adalimumab (ADA), infliximab (IFX), golimumab, and certolizumab pegol are the 5 drugs currently available on the market. This article aimed to evaluate the risk of TB infection from these 5 drugs for patients with RA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>We searched PubMed, EMBASE, COCHRANE library, OVID, and EBSCO for randomized controlled trials (RCT) of TNF-\u03b1 antagonist versus control and registry\/longitudinal cohort studies of 1 TNF-\u03b1 antagonist versus another. The Mantel-Haenszel test was adopted to analyze risk ratio (RR) in this metaanalysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Fifty RCT and 13 non-RCT were included in this study. No significant difference in TB risk was found in the RCT because of the short observational periods. In the non-RCT, TNF-\u03b1 antagonist was associated with a higher TB risk in patients with RA (RR 4.03, 95% CI 2.36\u20136.88), and the TB incidence rates of IFX and ADA were 2.78 and 3.88 times, respectively, higher than that of ETN. Further, preventive treatment for latent TB infection (LTBI) was shown to reduce the TB risk by 65% (RR 0.35, 95% CI 0.15\u20130.82).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>This study demonstrated a significant increase in TB risk in patients with RA treated with TNF-\u03b1 antagonists; among them, ETN is least likely to cause active TB. The study also proposes the necessity of LTBI prophylaxis in patients with RA.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.150057","type":"journal-article","created":{"date-parts":[[2015,10,16]],"date-time":"2015-10-16T01:48:17Z","timestamp":1444960097000},"page":"2229-2237","source":"Crossref","is-referenced-by-count":100,"title":["The Risk of Tuberculosis in Patients with Rheumatoid Arthritis Treated with Tumor Necrosis Factor-\u03b1 Antagonist: A Metaanalysis of Both Randomized Controlled Trials and Registry\/Cohort Studies"],"prefix":"10.3899","volume":"42","author":[{"given":"Jing-Wen","family":"Ai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiao-Ling","family":"Ruan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Qi","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing-Yan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi-Hui","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Hong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2262","published-online":{"date-parts":[[2015,10,15]]},"reference":[{"key":"2018112909350694000_42.12.2229.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2008.08.002"},{"key":"2018112909350694000_42.12.2229.2","doi-asserted-by":"publisher","DOI":"10.1002\/art.11301"},{"key":"2018112909350694000_42.12.2229.3","first-page":"iii","article-title":"A systematic review of the effectiveness of adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis in adults and an economic evaluation of their cost-effectiveness","volume":"10","author":"Chen","year":"2006","journal-title":"Health Technol"},{"key":"2018112909350694000_42.12.2229.4","doi-asserted-by":"publisher","DOI":"10.1002\/art.23721"},{"key":"2018112909350694000_42.12.2229.5","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00028510"},{"key":"2018112909350694000_42.12.2229.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62078-4"},{"key":"2018112909350694000_42.12.2229.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)05246-0"},{"key":"2018112909350694000_42.12.2229.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa011110"},{"key":"2018112909350694000_42.12.2229.9","first-page":"247","article-title":"[Tuberculosis in rheumatic patients treated with tumour necrosis factor alpha antagonists: the Portuguese experience]","volume":"31","author":"Fonseca","year":"2006","journal-title":"Acta Reumatol Port"},{"key":"2018112909350694000_42.12.2229.10","doi-asserted-by":"publisher","DOI":"10.1086\/506935"},{"key":"2018112909350694000_42.12.2229.11","unstructured":"Higgins JPT Green S , editors. 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