Tratamiento de Artritis reumatoide con antagonistas del factor de necrosis tumoral alfa y su asociación con el desarrollo de melanoma cutáneo: revisión sistemática de la literatura y meta-análisis.

Abstract

Introduction: Treatment with antagonists of the tumor necrosis factor alpha (anti- TNF) has impacted the prognosis and quality of life of patients with rheumatoid arthritis (RA) positively, however, there may be an incrased risk for cutaneous melanoma with this therapy. Objective: To determine the association between the use of anti- TNF and the development of malignant melanoma in patients with RA. Methods: A systematic search of MEDLINE, EMBASE, Cochrane Library and LILACS for clinical trials, observational studies, reviews and meta-analyzes in adult patients with RA diagnosis and management with anti TNF (certolizumab pegol, adalimumab, etanercept, infliximab and Golimumab) was performed. Results: 37 trials met the inclusion criteria for the meta-analysis, with a population of 16567 patients. The analysis of heterogeneity was not significant (p = 1), no difference was found in risk between the compared groups risk difference (RD) -0.00 (95% -0.001, -0.001). Further analysis of studies in which at least 1 case of melanoma (4222 patients) reported no difference in risk showed RD -0.00 (95% -0.004, -0.003). Conclusion: On the available evidence to date ther is no significant association between treatment with anti TNF and the development of cutaneous melanoma in patients with RA diagnosis.