Cardiovascular safety of tocilizumab: A systematic review and network meta-analysis

Benjamin Castagné, Marie Viprey, Julie Martin, Anne-Marie Schott, Michel Cucherat and Martin Soubrier

PLOS ONE, 2019, vol. 14, issue 8, 1-19

Abstract: Objectives: Our objective was to compare the cardiovascular safety of tocilizumab and other biological disease-modifying antirheumatic drugs (bDMARD) in rheumatoid arthritis using a network meta-analysis (NMA). Methods: A systematic literature search through May 2018 identified randomized controlled trials (RCT) or observational studies (cohort only) reporting cardiovascular outcomes of tocilizumab (TCZ) and/or abatacept (ABA) and/or rituximab (RTX) and/or tumor necrosis factor inhibitors (TNFi) in rheumatoid arthritis patients. The composite primary outcome was the rate of major adverse cardiovascular outcomes (MACE, myocardial infarction (MI), peripheral artery disease (PAD) and cardiac heart failure (CHF)). Results: 19 studies were included in the NMA, including 11 RCTs and 8 cohort studies. We found less events with RTX (5.41 [1.70;17.26]. We found no difference between TCZ and other treatments. Concerning MI, we found no difference between TCZ and csDMARD (4.23 [0.22;80.64]), no difference between TCZ and TNFi (2.00 [0.18;21.84]). There was no difference between TCZ and csDMARD (1.51[0.02;103.50] and between TCZ and TNFi (1.00 [0.06;15.85]) for stroke event. Conclusions: Despite an increase in cholesterol levels, TCZ has safe cardiovascular outcomes compared to other bDMARD.

Date: 2019
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0220178

DOI: 10.1371/journal.pone.0220178

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