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

Jeffrey A Sparks; Zachary S Wallace; Andrea M Seet; Milena A Gianfrancesco; Zara Izadi; Kimme L Hyrich; Anja Strangfeld; Laure Gossec; Loreto Carmona; Elsa F Mateus; Saskia Lawson-Tovey; Laura Trupin; Stephanie Rush; Patricia Katz; Gabriela Schmajuk; Lindsay Jacobsohn; Leanna Wise; Emily L Gilbert; Ali Duarte-Garcia; Maria O Valenzuela-Almada; Guillermo J Pons-Estel; Carolina A Isnardi; Guillermo A Berbotto; Tiffany y -T Hsu; Kristin M d'Silva; Naomi J Patel; Lianne Kearsley-Fleet; Martin Schäfer; Sandra Lúcia Euzébio Ribeiro; Samar Al Emadi; Liselotte Tidblad; Carlo Alberto Scirè; Bernd Raffeiner; Thierry Thomas; Rene-Marc Flipo; Jérôme Avouac; Raphaele Seror; Miguel Bernardes; Maria Margarida Cunha; Rebecca Hasseli; Hendrik Schulze-Koops; Ulf Müller-Ladner; Christof Specker; Viviane Angelina De Souza; Licia Maria Henrique Da Mota; Ana Paula Monteiro Gomides; Philippe Dieudé; Elena Nikiphorou; Vanessa L Kronzer; Namrata Singh; Manuel F Ugarte-Gil; Beth Wallace; Akpabio Akpabio; Ranjeny Thomas; Suleman Bhana; Wendy Costello; Rebecca Grainger; Jonathan S Hausmann; Jean W Liew; Emily Sirotich; Paul Sufka; Philip C Robinson; Pedro M Machado; Jinoos Yazdany

doi:10.1136/annrheumdis-2021-220418

Journal Articles Annals of the Rheumatic Diseases Year : 2021

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

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Jeffrey A Sparks

Function : Author

Zachary S Wallace

Function : Author

Andrea M Seet

Function : Author

Milena A Gianfrancesco

Function : Author

Zara Izadi

Function : Author

University of California

Kimme L Hyrich

Function : Author

Anja Strangfeld

Function : Author

Deutsches Rheuma-ForschungsZentrum

Laure Gossec

Function : Author

Institut Pierre Louis d'Epidémiologie et de Santé Publique

CHU Pitié-Salpêtrière [AP-HP]

Loreto Carmona

Function : Author

Instituto de Salud Musculoesqueletica

Elsa F Mateus

Function : Author

Saskia Lawson-Tovey

Function : Author

Laura Trupin

Function : Author

University of California

Stephanie Rush

Function : Author

University of California

Patricia Katz

Function : Author

University of California

Gabriela Schmajuk

Function : Author

University of California

Lindsay Jacobsohn

Function : Author

University of California

Leanna Wise

Function : Author

Emily L Gilbert

Function : Author

Ali Duarte-Garcia

Function : Author

Maria O Valenzuela-Almada

Function : Author

Guillermo J Pons-Estel

Function : Author

Carolina A Isnardi

Function : Author

Guillermo A Berbotto

Function : Author

Tiffany y -T Hsu

Function : Author

Kristin M d'Silva

Function : Author

Naomi J Patel

Function : Author

Lianne Kearsley-Fleet

Function : Author

University of Manchester [Manchester]

Martin Schäfer

Function : Author

Sandra Lúcia Euzébio Ribeiro

Function : Author

Samar Al Emadi

Function : Author

Liselotte Tidblad

Function : Author

Carlo Alberto Scirè

Function : Author

Bernd Raffeiner

Function : Author

Thierry Thomas

Function : Author

Rene-Marc Flipo

Function : Author

Hôpital Roger Salengro [Lille]

Jérôme Avouac

Function : Author

Service de rhumatologie [CHU Cochin]

Raphaele Seror

Function : Author

Miguel Bernardes

Function : Author

Maria Margarida Cunha

Function : Author

Rebecca Hasseli

Function : Author

Justus-Liebig-Universität Gießen = Justus Liebig University

Hendrik Schulze-Koops

Function : Author

Ludwig Maximilian University [Munich] = Ludwig Maximilians Universität München

Ulf Müller-Ladner

Function : Author

Justus-Liebig-Universität Gießen = Justus Liebig University

Christof Specker

Function : Author

Viviane Angelina De Souza

Function : Author

Licia Maria Henrique Da Mota

Function : Author

Ana Paula Monteiro Gomides

Function : Author

Philippe Dieudé

Function : Author

AP-HP - Hôpital Bichat - Claude Bernard [Paris]

Elena Nikiphorou

Function : Author

King‘s College London

Vanessa L Kronzer

Function : Author

Namrata Singh

Function : Author

Manuel F Ugarte-Gil

Function : Author

Beth Wallace

Function : Author

Akpabio Akpabio

Function : Author

Ranjeny Thomas

Function : Author

Suleman Bhana

Function : Author

Wendy Costello

Function : Author

Rebecca Grainger

Function : Author

University of Otago [Dunedin, Nouvelle-Zélande]

Jonathan S Hausmann

Function : Author

Jean W Liew

Function : Author

Emily Sirotich

Function : Author

McMaster University [Hamilton, Ontario]

Paul Sufka

Function : Author

Philip C Robinson

Function : Author

Pedro M Machado

Function : Author

Jinoos Yazdany

Function : Author

University of California

Abstract

Objective To investigate baseline use of biologic or targeted synthetic (b/ts) disease-modifying antirheumatic drugs (DMARDs) and COVID-19 outcomes in rheumatoid arthritis (RA). Methods We 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. Results Of 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. Conclusions People 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.

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Life Sciences [q-bio]

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Submitted on : Tuesday, December 13, 2022-10:23:31 AM

Last modification on : Friday, December 1, 2023-10:44:15 AM

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hal-03895851 , version 1 (13-12-2022)

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HAL Id : hal-03895851 , version 1
DOI : 10.1136/annrheumdis-2021-220418

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Jeffrey A Sparks, Zachary S Wallace, Andrea M Seet, Milena A Gianfrancesco, Zara Izadi, et al.. 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. Annals of the Rheumatic Diseases, 2021, 80 (9), pp.1137--1146. ⟨10.1136/annrheumdis-2021-220418⟩. ⟨hal-03895851⟩

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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

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