1. Leprosy detection rate in patients under immunosuppression for the treatment of dermatological, rheumatological, and gastroenterological diseases: a systematic review of the literature and meta-analysis.
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Barroso, Daniel Holanda, Brandão, Jurema Guerrieri, Andrade, Elaine Silva Nascimento, Correia, Ana Clara Banhatto, Aquino, Danielle Costa, Chen, Ana Carolina Rios, Vernal, Sebastian, de Araújo, Wildo Navegantes, da Mota, Lícia Maria Henrique, Sampaio, Raimunda Nonata Ribeiro, Kurizky, Patrícia Shu, and Gomes, Ciro Martins
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LEPROSY , *IMMUNOSUPPRESSION , *SCIENCE databases , *RHEUMATISM , *DRUG therapy for rheumatism , *SKIN diseases , *RESEARCH , *META-analysis , *RESEARCH methodology , *SYSTEMATIC reviews , *GASTROINTESTINAL diseases , *MEDICAL cooperation , *EVALUATION research , *COMPARATIVE studies , *TUMOR necrosis factors , *IMMUNOSUPPRESSIVE agents , *LONGITUDINAL method , *CHEMICAL inhibitors ,LEPROSY diagnosis - Abstract
Background: Recently developed immunosuppressive drugs, especially TNF antagonists, may enhance the risk of granulomatous infections, including leprosy. We aimed to evaluate the leprosy detection rate in patients under immunosuppression due to rheumatological, dermatological and gastroenterological diseases.Methods: We performed a systematic review of the literature by searching the PubMed, EMBASE, LILACS, Web of Science and Scielo databases through 2018. No date or language restrictions were applied. We included all articles that reported the occurrence of leprosy in patients under medication-induced immunosuppression.Results: The search strategy resulted in 15,103 articles; finally, 20 articles were included, with 4 reporting longitudinal designs. The detection rate of leprosy ranged from 0.13 to 116.18 per 100,000 patients/year in the USA and Brazil, respectively. In the meta-analysis, the detection rate of cases of leprosy per 100,000 immunosuppressed patients with rheumatic diseases was 84 (detection rate = 0.00084; 95% CI = 0.0000-0.00266; I2 = 0%, p = 0.55).Conclusion: Our analysis showed that leprosy was relatively frequently detected in medication-induced immunosuppressed patients suffering from rheumatological diseases, and further studies are needed. The lack of an active search for leprosy in the included articles precluded more precise conclusions.Trial Registration: This review is registered in PROSPERO with the registry number CRD42018116275 . [ABSTRACT FROM AUTHOR]- Published
- 2021
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