Systematic review and meta-analysis on the association of tuberculosis in Crohn’s disease patients treated with tumor necrosis factor-α inhibitors (Anti-TNFα)

Math 1 Math(A1).

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Figure 1 Evidence collection and selection.

Figure 2 Difference of the risk of Mycobacterium tuberculosis infection between patients with Crohn’s disease treated with tumor necrosis factor-alpha inhibitors and those treated with placebo. Risk difference was calculated after arcsine transformation of Mycobacterium tuberculosis incidence (Arcus sinus difference, ASD) and indicated by the numbers on x-axis. Weight: the percentage contribution of an individual study to the overall estimation. The x-axis indicates the risk difference. The vertical dashed line indicates the overall point estimate. The solid horizontal lines show the confidence interval (CI). The size of the black box and diamond is proportional to the corresponding weight.

Figure 3 Relationship between the estimated Mycobacterium tuberculosis infection risk difference and the corresponding standard error of the estimate. Risk difference was calculated after arcsine transformation of Mycobacterium tuberculosis incidence (Arcus sinus difference, ASD). The dashed vertical line indicates the overall arcsine difference found, and the diagonal lines indicate the expected 95% confidence intervals associated with the expected mean ASD for clinical trials with various numbers of study subjects.

Figure 4 Odds of patients developing active Mycobacterium tuberculosis when treated with tumor necrosis factor-alpha inhibitors for Crohn’s disease relative to those treated with placebo. Odds ratio (OR) was calculated using the Yusuf-Peto method and indicated by the numbers on the x-axis. Number of Mycobacterium tuberculosis cases was modified using the background Mycobacterium tuberculosis incidence, i.e., adding to the reported number of Mycobacterium tuberculosis cases with a number (less than 1) that might be expected from a given number of patients (listed under “Total”). Weight: the percentage contribution of an individual study to the pooled estimate. The vertical dashed line indicates the pooled odds ratio. The solid horizontal lines show the confidence interval (CI). The size of the black box and diamond is proportional to the corresponding weight. Mycobacterium tuberculosis here denotes tuberculosis.