Effect of tumor necrosis factor inhibitors on interstitial lung disease in rheumatoid arthritis: angel or demon?

Objectives: This study evaluated the correlation between tumor necrosis factor alpha inhibitor (TNF-I) and interstitial lung disease (ILD) in rheumatoid arthritis (RA). We aimed to raise awareness and consummate therapy by summarizing the characteristics of the adverse events of ILD.Methods: A comprehensive search of the PubMed, Embase, Ovid, Cochrane, China National Knowledge Infrastructure, and Wanfang databases was performed from inception to November 2018. Statistical analysis of demographic characteristics, clinical features, and relative risks was performed using Microsoft Excel 2007 and SPSS version 20.0.Results: A total of 7 eligible articles and another 28 case reports were enrolled. The 7 cohort studies demonstrated the tendency that ILD cases might not benefit from TNF-I therapy. TNF-I might be associated with ILD adverse events. The case reports further confirmed these findings, as most (87.5%) of the cases showed that TNF-1 was harmful to patients with ILD and even resulted in a 35% mortality rate. Further investigation revealed that ILD adverse events tended to appear in female patients with a long RA history (p

目的：本研究评估了类风湿关节炎（RA）中肿瘤坏死因子α抑制剂（TNF - I）与间质性肺病（ILD）之间的相关性。我们旨在通过总结ILD不良事件的特征来提高认识并完善治疗方法。 方法：从建库至2018年11月，对PubMed、Embase、Ovid、Cochrane、中国知网和万方数据库进行了全面检索。使用Microsoft Excel 2007和SPSS 20.0版对人口统计学特征、临床特征和相对风险进行统计分析。 结果：共纳入7篇符合条件的文章以及另外28份病例报告。7项队列研究显示出ILD病例可能无法从TNF - I治疗中获益的趋势。TNF - I可能与ILD不良事件相关。病例报告进一步证实了这些发现，因为大多数（87.5%）病例表明TNF - 1对ILD患者有害，甚至导致35%的死亡率。进一步调查显示，ILD不良事件往往出现在患有RA病史较长的女性患者中（p<......此处似乎内容不完整）