Role of targeted therapies in rheumatic patients on COVID-19 outcomes: results from the COVIDSER study
Por:
Gracia, J, Sanchez-Piedra, C, Manero, J, Ruiz-Lucea, M, Lopez-Vives, L, Bohorquez, C, Martinez-Barrio, J, Bonilla, G, Vela, P, Garcia-Villanueva, M, Navio-Marco, M, Pavia, M, Galindo, M, Erausquin, C, Gonzalez-Gay, M, Rua-Figueroa, I, Pego-Reigosa, J, Castrejon, I, Sanchez-Costa, J, Gonzalez-Davila, E, Diaz-Gonzalez, F and COVIDSER Study Grp
Publicada:
1 dic 2021
Resumen:
Objectives To analyse the effect of targeted therapies, either biological (b) disease-modifying antirheumatic drugs (DMARDs), targeted synthetic (ts) DMARDs and other factors (demographics, comorbidities or COVID-19 symptoms) on the risk of COVID-19 related hospitalisation in patients with inflammatory rheumatic diseases. Methods The COVIDSER study is an observational cohort including 7782 patients with inflammatory rheumatic diseases. Multivariable logistic regression was used to estimate ORs and 95% CIs of hospitalisation. Antirheumatic medication taken immediately prior to infection, demographic characteristics, rheumatic disease diagnosis, comorbidities and COVID-19 symptoms were analysed. Results A total of 426 cases of symptomatic COVID-19 from 1 March 2020 to 13 April 2021 were included in the analyses: 106 (24.9%) were hospitalised and 19 (4.4%) died. In multivariate-adjusted models, bDMARDs and tsDMARDs in combination were not associated with hospitalisation compared with conventional synthetic DMARDs (OR 0.55, 95% CI 0.24 to 1.25 of b/tsDMARDs, p=0.15). Tumour necrosis factor inhibitors (TNF-i) were associated with a reduced likelihood of hospitalisation (OR 0.32, 95% CI 0.12 to 0.82, p=0.018), whereas rituximab showed a tendency to an increased risk of hospitalisation (OR 4.85, 95% CI 0.86 to 27.2). Glucocorticoid use was not associated with hospitalisation (OR 1.69, 95% CI 0.81 to 3.55). A mix of sociodemographic factors, comorbidities and COVID-19 symptoms contribute to patients' hospitalisation. Conclusions The use of targeted therapies as a group is not associated with COVID-19 severity, except for rituximab, which shows a trend towards an increased risk of hospitalisation, while TNF-i was associated with decreased odds of hospitalisation in patients with rheumatic disease. Other factors like age, male gender, comorbidities and COVID-19 symptoms do play a role.
Filiaciones:
Gracia, J:
Hosp Gen Univ Gregorio Maranon, Dept Rheumatol, Madrid, Spain
Sanchez-Piedra, C:
Soc Espanola Reumatol, Res Unit, Madrid, Spain
Manero, J:
Hosp Univ Miguel Servet, Rheumatol Dept, Zaragoza, Aragon, Spain
Ruiz-Lucea, M:
Hosp Univ Basurto, Rheumatol Dept, Bilbao, Pais Vasco, Spain
Lopez-Vives, L:
Hosp San Rafael, Rheumatol Dept, Barcelona, Catalunya, Spain
Bohorquez, C:
Hosp Univ Principe Asturias, Dept Rheumatol, Madrid, Spain
Martinez-Barrio, J:
Hosp Gen Univ Gregorio Maranon, Dept Rheumatol, Madrid, Spain
Bonilla, G:
La Paz Univ Hosp, Dept Rheumatol, Madrid, Spain
:
Hosp Gen Univ Alicante, Dept Rheumatol, Alicante, Spain
Garcia-Villanueva, M:
Hosp Univ Ramon y Cajal, Dept Rheumatol, Madrid, Spain
Navio-Marco, M:
Hosp Univ Infanta Leonor, Dept Rheumatol, Madrid, Spain
Pavia, M:
Hosp Univ Puerta Hierro Majadahonda, Dept Rheumatol, Majadahonda, Comunidad De Ma, Spain
Galindo, M:
Hosp Univ 12 Octubre, Dept Rheumatol, Madrid, Comunidad De Ma, Spain
Erausquin, C:
Hosp Doctor Negrin, Dept Rheumatol, Las Palmas Gran Canaria, Spain
Gonzalez-Gay, M:
Hosp Univ Marques Valdecilla, Dept Rheumatol, Santander, Cantabria, Spain
Rua-Figueroa, I:
Hosp Doctor Negrin, Dept Rheumatol, Las Palmas Gran Canaria, Spain
Pego-Reigosa, J:
Univ Hosp Complex Vigo, Dept Rheumatol, Vigo, Spain
Castrejon, I:
Hosp Gen Univ Gregorio Maranon, Dept Rheumatol, Madrid, Spain
Sanchez-Costa, J:
Soc Espanola Reumatol, Res Unit, Madrid, Spain
Gonzalez-Davila, E:
Univ La Laguna, Dept Estadist & Invest Operat, San Cristobal la Laguna, Islas Canarias, Spain
Diaz-Gonzalez, F:
Hosp Univ Canarias, Dept Rheumatol, San Cristobal la Laguna, Spain
Univ La Laguna, Dept Internal Med & Psychiat, San Cristobal la Laguna, Spain
Green Published, gold
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