Risk of COVID-19 infection, hospitalization and mortality in psoriasis patients treated with interleukin-17 inhibitors: A systematic review and meta-analysis
BackgroundCoronavirus disease 2019 (COVID-19) have brought great disaster to mankind, and there is currently no globally recognized specific drug or treatment. Severe COVID-19 may trigger a cytokine storm, manifested by increased levels of cytokines including interleukin-17 (IL-17), so a new strateg...
Main Authors: | , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Frontiers Media S.A.
2022-10-01
|
Series: | Frontiers in Immunology |
Subjects: | |
Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2022.1046352/full |
_version_ | 1797989890118385664 |
---|---|
author | Meitong Liu Huijuan Wang Lu Liu Saijin Cui Xiangran Huo Zhuoyun Xiao Yaning Zhao Bin Wang Guoqiang Zhang Guoqiang Zhang Na Wang |
author_facet | Meitong Liu Huijuan Wang Lu Liu Saijin Cui Xiangran Huo Zhuoyun Xiao Yaning Zhao Bin Wang Guoqiang Zhang Guoqiang Zhang Na Wang |
author_sort | Meitong Liu |
collection | DOAJ |
description | BackgroundCoronavirus disease 2019 (COVID-19) have brought great disaster to mankind, and there is currently no globally recognized specific drug or treatment. Severe COVID-19 may trigger a cytokine storm, manifested by increased levels of cytokines including interleukin-17 (IL-17), so a new strategy to treat COVID-19 may be to use existing IL-17 inhibitors, which have demonstrated efficacy, safety and tolerability in the treatment of psoriasis. However, the use of IL-17 inhibitors in patients with psoriasis during the COVID-19 pandemic remains controversial due to reports that IL-17 inhibitors may increase the risk of respiratory tract infections.ObjectivesThe systematic review and meta-analysis aimed to evaluate the effect of IL-17 inhibitors on the risk of COVID-19 infection, hospitalization, and mortality in patients with psoriasis.MethodsDatabases (including Embase, PubMed, SCI-Web of Science, Scopus, CNKI, and the Cochrane Library) were searched up to August 23, 2022, for studies exploring differences in COVID-19 outcomes between psoriasis patients using IL-17 inhibitors and those using non-biologics. Two authors independently extracted data and assessed the risk of bias in a double-blind manner. The risk ratios (RRs) and 95% confidence intervals (CIs) were calculated and heterogeneities were determined by the Q test and I2 statistic. And the numbers needed to treat (NNTs) were calculated to assess the clinical value of IL-17 inhibitors in preventing SARS-CoV-2 infection and treating COVID-19.ResultsNine observational studies involving 7,106 participants were included. The pooled effect showed no significant differences in the rates of SARS-CoV-2 infection (P = 0.94; I2 = 19.5%), COVID-19 hospitalization (P = 0.64; I2 = 0.0%), and COVID-19 mortality (P = 0.32; I2 = 0.0%) in psoriasis patients using IL-17 inhibitors compared with using non-biologics. Subgroup analyses grouped by age and COVID-19 cases, respectively, revealed consistent results as above. Meanwhile, the pooled NNTs showed no significant differences between the two groups in the clinical value of preventing SARS-CoV-2 infection and treating COVID-19.ConclusionThe use of IL-17 inhibitors in patients with psoriasis does not increase the risk of SARS-CoV-2 infection or worsen the course of COVID-19.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022335195. |
first_indexed | 2024-04-11T08:27:53Z |
format | Article |
id | doaj.art-53a772f536364487968df06422a9b3ed |
institution | Directory Open Access Journal |
issn | 1664-3224 |
language | English |
last_indexed | 2024-04-11T08:27:53Z |
publishDate | 2022-10-01 |
publisher | Frontiers Media S.A. |
record_format | Article |
series | Frontiers in Immunology |
spelling | doaj.art-53a772f536364487968df06422a9b3ed2022-12-22T04:34:40ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-10-011310.3389/fimmu.2022.10463521046352Risk of COVID-19 infection, hospitalization and mortality in psoriasis patients treated with interleukin-17 inhibitors: A systematic review and meta-analysisMeitong Liu0Huijuan Wang1Lu Liu2Saijin Cui3Xiangran Huo4Zhuoyun Xiao5Yaning Zhao6Bin Wang7Guoqiang Zhang8Guoqiang Zhang9Na Wang10Cancer Institute, The Fourth Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, ChinaCancer Institute, The Fourth Hospital of Hebei Medical University, Shijiazhuang, ChinaCancer Institute, The Fourth Hospital of Hebei Medical University, Shijiazhuang, ChinaCancer Institute, The Fourth Hospital of Hebei Medical University, Shijiazhuang, ChinaCancer Institute, The Fourth Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, ChinaCandidate Branch of National Clinical Research Center for Skin Diseases, Shijiazhuang, ChinaCancer Institute, The Fourth Hospital of Hebei Medical University, Shijiazhuang, ChinaBackgroundCoronavirus disease 2019 (COVID-19) have brought great disaster to mankind, and there is currently no globally recognized specific drug or treatment. Severe COVID-19 may trigger a cytokine storm, manifested by increased levels of cytokines including interleukin-17 (IL-17), so a new strategy to treat COVID-19 may be to use existing IL-17 inhibitors, which have demonstrated efficacy, safety and tolerability in the treatment of psoriasis. However, the use of IL-17 inhibitors in patients with psoriasis during the COVID-19 pandemic remains controversial due to reports that IL-17 inhibitors may increase the risk of respiratory tract infections.ObjectivesThe systematic review and meta-analysis aimed to evaluate the effect of IL-17 inhibitors on the risk of COVID-19 infection, hospitalization, and mortality in patients with psoriasis.MethodsDatabases (including Embase, PubMed, SCI-Web of Science, Scopus, CNKI, and the Cochrane Library) were searched up to August 23, 2022, for studies exploring differences in COVID-19 outcomes between psoriasis patients using IL-17 inhibitors and those using non-biologics. Two authors independently extracted data and assessed the risk of bias in a double-blind manner. The risk ratios (RRs) and 95% confidence intervals (CIs) were calculated and heterogeneities were determined by the Q test and I2 statistic. And the numbers needed to treat (NNTs) were calculated to assess the clinical value of IL-17 inhibitors in preventing SARS-CoV-2 infection and treating COVID-19.ResultsNine observational studies involving 7,106 participants were included. The pooled effect showed no significant differences in the rates of SARS-CoV-2 infection (P = 0.94; I2 = 19.5%), COVID-19 hospitalization (P = 0.64; I2 = 0.0%), and COVID-19 mortality (P = 0.32; I2 = 0.0%) in psoriasis patients using IL-17 inhibitors compared with using non-biologics. Subgroup analyses grouped by age and COVID-19 cases, respectively, revealed consistent results as above. Meanwhile, the pooled NNTs showed no significant differences between the two groups in the clinical value of preventing SARS-CoV-2 infection and treating COVID-19.ConclusionThe use of IL-17 inhibitors in patients with psoriasis does not increase the risk of SARS-CoV-2 infection or worsen the course of COVID-19.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022335195.https://www.frontiersin.org/articles/10.3389/fimmu.2022.1046352/fullCOVID-19interleukin-17 inhibitorspsoriasisNNTmeta-analysissystematic review |
spellingShingle | Meitong Liu Huijuan Wang Lu Liu Saijin Cui Xiangran Huo Zhuoyun Xiao Yaning Zhao Bin Wang Guoqiang Zhang Guoqiang Zhang Na Wang Risk of COVID-19 infection, hospitalization and mortality in psoriasis patients treated with interleukin-17 inhibitors: A systematic review and meta-analysis Frontiers in Immunology COVID-19 interleukin-17 inhibitors psoriasis NNT meta-analysis systematic review |
title | Risk of COVID-19 infection, hospitalization and mortality in psoriasis patients treated with interleukin-17 inhibitors: A systematic review and meta-analysis |
title_full | Risk of COVID-19 infection, hospitalization and mortality in psoriasis patients treated with interleukin-17 inhibitors: A systematic review and meta-analysis |
title_fullStr | Risk of COVID-19 infection, hospitalization and mortality in psoriasis patients treated with interleukin-17 inhibitors: A systematic review and meta-analysis |
title_full_unstemmed | Risk of COVID-19 infection, hospitalization and mortality in psoriasis patients treated with interleukin-17 inhibitors: A systematic review and meta-analysis |
title_short | Risk of COVID-19 infection, hospitalization and mortality in psoriasis patients treated with interleukin-17 inhibitors: A systematic review and meta-analysis |
title_sort | risk of covid 19 infection hospitalization and mortality in psoriasis patients treated with interleukin 17 inhibitors a systematic review and meta analysis |
topic | COVID-19 interleukin-17 inhibitors psoriasis NNT meta-analysis systematic review |
url | https://www.frontiersin.org/articles/10.3389/fimmu.2022.1046352/full |
work_keys_str_mv | AT meitongliu riskofcovid19infectionhospitalizationandmortalityinpsoriasispatientstreatedwithinterleukin17inhibitorsasystematicreviewandmetaanalysis AT huijuanwang riskofcovid19infectionhospitalizationandmortalityinpsoriasispatientstreatedwithinterleukin17inhibitorsasystematicreviewandmetaanalysis AT luliu riskofcovid19infectionhospitalizationandmortalityinpsoriasispatientstreatedwithinterleukin17inhibitorsasystematicreviewandmetaanalysis AT saijincui riskofcovid19infectionhospitalizationandmortalityinpsoriasispatientstreatedwithinterleukin17inhibitorsasystematicreviewandmetaanalysis AT xiangranhuo riskofcovid19infectionhospitalizationandmortalityinpsoriasispatientstreatedwithinterleukin17inhibitorsasystematicreviewandmetaanalysis AT zhuoyunxiao riskofcovid19infectionhospitalizationandmortalityinpsoriasispatientstreatedwithinterleukin17inhibitorsasystematicreviewandmetaanalysis AT yaningzhao riskofcovid19infectionhospitalizationandmortalityinpsoriasispatientstreatedwithinterleukin17inhibitorsasystematicreviewandmetaanalysis AT binwang riskofcovid19infectionhospitalizationandmortalityinpsoriasispatientstreatedwithinterleukin17inhibitorsasystematicreviewandmetaanalysis AT guoqiangzhang riskofcovid19infectionhospitalizationandmortalityinpsoriasispatientstreatedwithinterleukin17inhibitorsasystematicreviewandmetaanalysis AT guoqiangzhang riskofcovid19infectionhospitalizationandmortalityinpsoriasispatientstreatedwithinterleukin17inhibitorsasystematicreviewandmetaanalysis AT nawang riskofcovid19infectionhospitalizationandmortalityinpsoriasispatientstreatedwithinterleukin17inhibitorsasystematicreviewandmetaanalysis |