02546nas a2200325   4500000000100000008004100001260001200042653002300054653002200077653001200099653003800111100001400149700001500163700001600178700001400194700001300208700001100221700001300232700001800245700001400263700002300277700001400300700001300314245020800327856008400535300000800619490000700627520157200634022001402206       2021                            d  c04/202110aBiological therapy10aImmunosuppressors10aleprosy10aTumour necrosis factor inhibitors1 aBarroso D1 aBrandão J1 aAndrade ESN1 aCorreia A1 aAquino D1 aChen A1 aVernal S1 ade Araújo WN1 ada Mota L1 aRibeiro Sampaio RN1 aKurizky P1 aGomes CM00aLeprosy detection rate in patients under immunosuppression for the treatment of dermatological, rheumatological, and gastroenterological diseases: a systematic review of the literature and meta-analysis.  uhttps://bmcinfectdis.biomedcentral.com/track/pdf/10.1186/s12879-021-06041-7.pdf  a3470 v213 a<p><b>BACKGROUND: </b>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.</p><p><b>METHODS: </b>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.</p><p><b>RESULTS: </b>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; I = 0%, p = 0.55).</p><p><b>CONCLUSION: </b>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.</p><p><b>TRIAL REGISTRATION: </b>This review is registered in PROSPERO with the registry number CRD42018116275 .</p>  a1471-2334