Background: Biologic therapies have all demonstrated efficacy inside the treatment of AS. however, some patients do not reply to remedy (i.e., number one treatment failure) or enjoy diminished efficacy over the years (i.e., secondary treatment failure), while others experience side effects necessitating treatment discontinuation e.g. (incidence of malignancies). Aim: This work aims to assess the incidence of malignancies in spondyloarthritis (SpA) patients treated with biologics. Materials and Methods: A systematic search was performed over different medical databases to identify Internal Medicine studies, which studied the outcome of the Biologics group versus the Non-biologics group of spondyloarthritis (SpA) patients. Using the meta-analysis process, either with fixed or random-effects models, we conducted a meta-analysis on the overall incidence of malignancy as a primary outcome, and on the incidence of malignancy in TNF-A and IL-17 therapies (as secondary outcomes). Results: Eleven studies were identified involving 4395 patients, with 2878 patients in the Biologics group, and 1517 patients in the Non-biologics group. The meta-analysis process revealed a non-significant difference in the overall incidence of malignancy in the Biologics group compared to the Non-biologics group (p > 0.05), with also a non-significant difference in the incidence of malignancy in TNF-A and IL-17 users (p > 0.05). Conclusion: To conclude, we found no evidence for elevated risk of malignancy with the use of biologics in SpA. We were also unable to assess the long-term risk of biologics in SpA, which requires longer follow-up durations, and further investigatory studies.
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