Tumor necrosis factor-alpha plays a vital role in the immunologic process. Patients receiving anti-TNFα therapy may likely be more predisposed to infections, including sinus disorders.

The researchers aimed to review the literature and evaluate data regarding TNFα antagonist therapy and its association concerning various sinus disorders in the form of a systematic review and meta-analysis.

A thorough review of literature searches extracted 1154 records. After initial screening, seventeen papers fulfilled our criteria for inclusion into the meta-analysis. Among 16 174 observed patients, 3018 suffered from a sinus infection. An event rate (ER) of 0.058 was calculated for all the cases. Analysis concerning the confirmed diseases showed an 0.038 ER. Calculations were performed following the diagnostic categories used for a sinus disorder. Six groups were found, including the following: “Bacterial Sinusitis” (ER: 0.046), “Chronic Rhinosinusitis” (ER: 0.027), “Sinusitis Requiring Prescription Medication” (ER: 0.295), “Recurrent Sinusitis” (ER: 0.070), “Sinusitis” (ER: 0.076), “Acute Rhinosinusitis” (ER: 0.002) and, lastly, “Maxillary Sinusitis” (ER: 0.028).

The study demonstrated a similar prevalence to the healthy population; therefore, infective sinus disorders cannot directly be considered as complications of TNFα antagonist therapy.

Reference: https://journals.sagepub.com/doi/full/10.1177/1945892419898988

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