A systematic review and meta-analysis of mycobacterial infections in patients with idiopathic inflammatory myopathies.
Rheumatology (Oxford)
; 61(9): 3521-3533, 2022 08 30.
Article
in English
| MEDLINE | ID: covidwho-1662131
ABSTRACT
OBJECTIVES:
Infections including tuberculosis (TB) are a leading cause of morbidity and mortality in idiopathic inflammatory myopathies (IIM). We systematically reviewed the prevalence of mycobacterial infections in patients with IIM.METHODS:
We screened PUBMED, EMBASE and SCOPUS databases and conference abstracts (2015-20) for original articles using Covidence. Pooled estimates of prevalence were calculated.RESULTS:
Of 83 studies (28 cohort studies, two case control and 53 case reports), 19 were analysed. Of 14 043 IIM patients, DM (54.41%) was the most common subset among TB. Most studies were from Asia with high prevalence (5.86%, 2.33%-10.60%). Pooled prevalence of mycobacterial infections among IIM was 3.58% (95% CI 2.17%, 5.85%, P < 0.01). Disseminated and extrapulmonary forms (46.58%; 95% CI 39.02%, 54.31%, P = 1.00) were as common as pulmonary TB (49.07%; 95% CI 41.43%, 56.75%, P =0.99) both for I2=0. Muscle involvement, an otherwise rare site, was frequently seen in case reports (24.14%). M. tuberculosis (28.84%) was the most common pathogen followed by Mycobacterium avium complex (3.25%). Non-tuberculous mycobacteria were less common overall (6.25; 95% CI 3.49%, 10.93%) I2=0, P =0.94. Subgroup analysis and meta-regression based on high vs low TB regions found prevalence 6.61% (2.96%, 11.33%) in high TB regions vs 2.05% (0.90%, 3.56%) in low TB regions. While death due to TB was occasionally reported (P =0.82), successful anti-tubercular treatment was common (13.95%).CONCLUSION:
TB is common in IIM, particularly in endemic regions though current data is largely heterogeneous. Extra-pulmonary forms and atypical sites including the muscle are frequent. Limited data suggests fair outcomes, although larger prospective studies may offer better understanding.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Tuberculosis
/
Tuberculosis, Pulmonary
/
Mycobacterium tuberculosis
/
Myositis
Type of study:
Cohort study
/
Observational study
/
Prognostic study
/
Reviews
/
Systematic review/Meta Analysis
Limits:
Humans
Language:
English
Journal:
Rheumatology (Oxford)
Journal subject:
Rheumatology
Year:
2022
Document Type:
Article
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