1. Associations of baseline use of biologic or targeted synthetic DMARDs with COVID-19 severity in rheumatoid arthritis: Results from the COVID-19 Global Rheumatology Alliance physician registry
- Author
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Maria Margarida Cunha, Gabriela Schmajuk, Rebecca Hasseli, Namrata Singh, Tiffany Y.T. Hsu, Milena A. Gianfrancesco, Anja Strangfeld, Ranjeny Thomas, Naomi J Patel, Thierry Thomas, Philippe Dieudé, Kimme L. Hyrich, Emily Sirotich, Laura Trupin, Liselotte Tidblad, Jinoos Yazdany, René Marc Flipo, Licia Maria Henrique da Mota, Andrea M Seet, Samar Al Emadi, Carolina A. Isnardi, Saskia Lawson-Tovey, Alí Duarte-García, Hendrik Schulze-Koops, Manuel F. Ugarte-Gil, Vanessa L. Kronzer, Philip Robinson, Lindsay Jacobsohn, Elsa F Mateus, Pedro Machado, Ana Paula Monteiro Gomides, Jean W. Liew, Guillermo A. Berbotto, Miguel Bernardes, Patricia P. Katz, Martin Schäfer, Guillermo J. Pons-Estel, Ulf Müller-Ladner, Jeffrey A. Sparks, Elena Nikiphorou, Christof Specker, Paul Sufka, Zara Izadi, Loreto Carmona, Stephanie Rush, Sandra Lúcia Euzébio Ribeiro, Maria O Valenzuela-Almada, Kristin M. D’Silva, Emily L Gilbert, Raphaèle Seror, Laure Gossec, Beth I Wallace, Viviane Angelina de Souza, Akpabio Akpabio, Jérôme Avouac, Leanna Wise, Wendy Costello, Zachary S. Wallace, Suleman Bhana, Jonathan S. Hausmann, Lianne Kearsley-Fleet, Bernd Raffeiner, Carlo Alberto Scirè, Rebecca Grainger, Sparks, J, Wallace, Z, Seet, A, Gianfrancesco, M, Izadi, Z, Hyrich, K, Strangfeld, A, Gossec, L, Carmona, L, Mateus, E, Lawson-Tovey, S, Trupin, L, Rush, S, Katz, P, Schmajuk, G, Jacobsohn, L, Wise, L, Gilbert, E, Duarte-Garcia, A, Valenzuela-Almada, M, Pons-Estel, G, Isnardi, C, Berbotto, G, Hsu, T, D'Silva, K, Patel, N, Kearsley-Fleet, L, Schafer, M, Ribeiro, S, Al Emadi, S, Tidblad, L, Scire, C, Raffeiner, B, Thomas, T, Flipo, R, Avouac, J, Seror, R, Bernardes, M, Cunha, M, Hasseli, R, Schulze-Koops, H, Muller-Ladner, U, Specker, C, De Souza, V, Da Mota, L, Gomides, A, Dieude, P, Nikiphorou, E, Kronzer, V, Singh, N, Ugarte-Gil, M, Wallace, B, Akpabio, A, Thomas, R, Bhana, S, Costello, W, Grainger, R, Hausmann, J, Liew, J, Sirotich, E, Sufka, P, Robinson, P, Machado, P, and Yazdany, J more...
- Subjects
Male ,medicine.medical_specialty ,abatacept ,Coronavirus disease 2019 (COVID-19) ,Immunology ,tumour necrosis factor inhibitors ,tumour necrosis factor inhibitor ,Antirheumatic Agents/therapeutic use ,Rheumatoid Arthritis ,Severity of Illness Index ,General Biochemistry, Genetics and Molecular Biology ,Arthritis, Rheumatoid ,03 medical and health sciences ,0302 clinical medicine ,rituximab ,Rheumatology ,Arthritis, Rheumatoid/complications ,Internal medicine ,medicine ,Immunology and Allergy ,Humans ,030212 general & internal medicine ,Registries ,Interleukin 6 ,Aged ,030203 arthritis & rheumatology ,biology ,business.industry ,SARS-CoV-2 ,Abatacept ,Confounding ,COVID-19 ,rheumatoid arthriti ,Middle Aged ,medicine.disease ,Drug class ,Rheumatoid arthritis ,Antirheumatic Agents ,COVID-19/complications ,biology.protein ,Rituximab ,Female ,business ,medicine.drug - Abstract
ObjectiveTo investigate baseline use of biologic or targeted synthetic (b/ts) disease-modifying antirheumatic drugs (DMARDs) and COVID-19 outcomes in rheumatoid arthritis (RA).MethodsWe analysed the COVID-19 Global Rheumatology Alliance physician registry (from 24 March 2020 to 12 April 2021). We investigated b/tsDMARD use for RA at the clinical onset of COVID-19 (baseline): abatacept (ABA), rituximab (RTX), Janus kinase inhibitors (JAKi), interleukin 6 inhibitors (IL-6i) or tumour necrosis factor inhibitors (TNFi, reference group). The ordinal COVID-19 severity outcome was (1) no hospitalisation, (2) hospitalisation without oxygen, (3) hospitalisation with oxygen/ventilation or (4) death. We used ordinal logistic regression to estimate the OR (odds of being one level higher on the ordinal outcome) for each drug class compared with TNFi, adjusting for potential baseline confounders.ResultsOf 2869 people with RA (mean age 56.7 years, 80.8% female) on b/tsDMARD at the onset of COVID-19, there were 237 on ABA, 364 on RTX, 317 on IL-6i, 563 on JAKi and 1388 on TNFi. Overall, 613 (21%) were hospitalised and 157 (5.5%) died. RTX (OR 4.15, 95% CI 3.16 to 5.44) and JAKi (OR 2.06, 95% CI 1.60 to 2.65) were each associated with worse COVID-19 severity compared with TNFi. There were no associations between ABA or IL6i and COVID-19 severity.ConclusionsPeople with RA treated with RTX or JAKi had worse COVID-19 severity than those on TNFi. The strong association of RTX and JAKi use with poor COVID-19 outcomes highlights prioritisation of risk mitigation strategies for these people. more...
- Published
- 2021
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