Association of Interleukin-17 Inhibitors With Hypertension in Patients With Autoimmune Diseases: A Systematic Review and Meta-analysis on Randomized Controlled Trials

被引:1
作者
Jiang, Kexin [1 ,2 ]
Jia, Yuheng [1 ,2 ]
Chen, Li [3 ]
Huang, Fangyang [1 ,2 ]
Chen, Mao [1 ,2 ]
机构
[1] Sichuan Univ, West China Hosp, Dept Cardiol, Chengdu 610041, Peoples R China
[2] Sichuan Univ, West China Hosp, Lab Heart Valve Dis, Chengdu, Peoples R China
[3] Sichuan Univ, West China Hosp, Regenerat Med Res Ctr, Lab Cardiovasc Dis, Chengdu, Peoples R China
基金
中国国家自然科学基金;
关键词
anti-IL-17; agents; hypertension; autoimmune disease; PSORIATIC-ARTHRITIS; PLAQUE PSORIASIS; RENAL INJURY; EFFICACY; SAFETY; RISK; SECUKINUMAB; DYSFUNCTION; BRODALUMAB;
D O I
10.1097/FJC.0000000000001547
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Supplemental Digital Content is Available in the Text. The influence of interleukin (IL)-17 inhibition on blood pressure in patients with autoimmune diseases remains inconclusive. Our objective is to examine the risk of hypertension in patients with autoimmune diseases undergoing IL-17 inhibition therapies through meta-analysis of randomized, placebo-controlled trials. We obtained integrated data from PubMed, Embase, and ClinicalTrials.gov. Incident hypertension rates were calculated, and hazard ratios with 95% confidence intervals were analyzed, along with Iota 2statistics to assess heterogeneity. Sequential analysis ensured conclusion reliability. In 30 randomized controlled trials involving 9909 patients with diverse autoimmune diseases treated with anti-IL-17 agents, our meta-analysis revealed a significant increase in hypertension risk (risk ratio 1.69, 95% confidence interval 1.24-2.31, P = 0.001), robustly supported by trial sequential analysis. Among the 4 agents (secukinumab, ixekizumab, bimekizumab, and brodalumab), only secukinumab exhibited a notable association with hypertension. Patients with various primary autoimmune diseases, particularly those with psoriatic arthritis, had a higher likelihood of developing hypertension; in rheumatic arthritis patient cohorts, anti-IL-17 agents did not elevate hypertension risk. Prolonged treatment duration correlated with an increased hypertension risk. Stratifying by sex, studies with a female predominance demonstrated a higher risk ratio for hypertension compared with male-predominant studies. This highlights that anti-IL-17 treatment escalates hypertension risk, emphasizing the need for extra caution when managing patients with autoimmune diseases (Registered by PROSPERO, CRD42016053112).
引用
收藏
页码:557 / 564
页数:8
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