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Anti-TNF drugs for chronic uveitis in adults : a systematic review and meta-analysis of randomized controlled trials

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dc.contributor.authorLeal, Ines
dc.contributor.authorRodrigues, Filipe Brogueira
dc.contributor.authorSousa, David Cordeiro
dc.contributor.authorDuarte, Gonçalo Silva
dc.contributor.authorRomão, Vasco C.
dc.contributor.authorMarques-Neves, Carlos
dc.contributor.authorCosta, João
dc.contributor.authorFonseca, João Eurico
dc.date.accessioned2019-11-14T14:54:45Z
dc.date.available2019-11-14T14:54:45Z
dc.date.issued2019
dc.descriptionCopyright © 2019 Leal, Rodrigues, Sousa, Duarte, Romão, Marques-Neves, Costa and Fonseca. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.pt_PT
dc.description.abstractBackground: We aimed to assess efficacy and safety of anti-tumor necrosis factor (TNF) drugs for adult chronic non-infectious uveitis (NIU). Methods: CENTRAL, MEDLINE, and EMBASE, were searched from inception to January 2019. Double-masked randomized placebo-controlled trials, assessing any anti-TNF vs. best medical intervention/standard of care in adults with chronic NIU were considered. The PRISMA and SAMPL guidelines were followed. The risk of bias was assessed using the Cochrane risk of bias tool. Overall quality of the evidence was assessed according to GRADE. PROSPERO registration: #CRD42016039068. The primary efficacy and safety outcomes were preservation of visual acuity (VA) and withdrawals due to adverse events, respectively. Meta-analysis of efficacy analysis was not performed due to significant clinical heterogeneity between studies' population and interventions. Results: A total of 1,157 references were considered and 3 studies were included. The overall risk of bias was moderate. In active NIU, adalimumab group showed an increased likelihood of VA preservation (risk ratio (RR) 1.75, 95%CI 1.32 to 2.32, n = 217), whereas the etanercept group did not (RR 0.81, 95%CI 0.57 to 1.14, n = 20). In inactive NIU, adalimumab was associated with increased likelihood of VA preservation (RR 1.31, 95%CI 1.12 to 1.53, n = 226). The rate of adverse events did not differ between anti-TNF and control arms (RR 1.03, 95%CI 0.94 to 1.13, n = 410). Conclusions: There is high quality evidence that adalimumab decreases the risk of worsening VA in active and inactive NIU and very low quality evidence that the risk of etanercept worsening VA in inactive NIU is not different from placebo. Moderate quality evidence suggests that anti-TNF agents are not different from placebo on the risk of study withdrawal.pt_PT
dc.description.sponsorshipThis project received a research grant from a non-profit and scientific organization, Portuguese Society of Ophthalmology (Sociedade Portuguesa de Oftalmologia). UID/BIM/50005/2019, project funded by Fundação para a Ciência e a Tecnologia (FCT)/Ministério da Ciência, Tecnologia e Ensino Superior (MCTES) through Fundos do Orçamento de Estado (Portuguese State Funding).pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationFrontiers in Medicine | May 2019 | Volume 6 | Article 104pt_PT
dc.identifier.doi10.3389/fmed.2019.00104pt_PT
dc.identifier.eissn2296-858X
dc.identifier.urihttp://hdl.handle.net/10451/40142
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherFrontiers Mediapt_PT
dc.relationInstituto de Medicina Molecular
dc.relation.publisherversionhttps://www.frontiersin.org/journals/medicinept_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectNon-infectious uveitispt_PT
dc.subjectAnti-tumor necrosis factor drugspt_PT
dc.subjectAdalimumabpt_PT
dc.subjectEtanerceptpt_PT
dc.subjectSafetypt_PT
dc.subjectEfficacypt_PT
dc.titleAnti-TNF drugs for chronic uveitis in adults : a systematic review and meta-analysis of randomized controlled trialspt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.awardNumberUID/BIM/50005/2019
oaire.awardTitleInstituto de Medicina Molecular
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UID%2FBIM%2F50005%2F2019/PT
oaire.citation.startPage104pt_PT
oaire.citation.titleFrontiers in Medicinept_PT
oaire.citation.volume6pt_PT
oaire.fundingStream6817 - DCRRNI ID
person.familyNameLeal
person.familyNameRodrigues
person.familyNameSousa
person.familyNameDuarte
person.familyNameC Romão
person.familyNameMarques Neves
person.familyNameCosta
person.familyNameFonseca
person.givenNameInes
person.givenNameFilipe Brogueira
person.givenNameDavid Cordeiro
person.givenNameGonçalo
person.givenNameVasco
person.givenNameCarlos
person.givenNameJoão
person.givenNameJoão
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person.identifier.ciencia-idC119-D580-13D6
person.identifier.ciencia-idF310-B85D-57C7
person.identifier.orcid0000-0001-9622-8779
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person.identifier.orcid0000-0002-5831-4921
person.identifier.orcid0000-0003-1432-3671
person.identifier.ridR-2679-2017
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project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameFundação para a Ciência e a Tecnologia
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
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