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 - Sorbonne Université Access content directly
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

Jeffrey A Sparks
  • Function : Author
Zachary S Wallace
  • Function : Author
Andrea M Seet
  • Function : Author
Milena A Gianfrancesco
  • Function : Author
Kimme L Hyrich
  • Function : Author
Elsa F Mateus
  • Function : Author
Saskia Lawson-Tovey
  • Function : Author
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
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
Jérôme Avouac
Raphaele Seror
  • Function : Author
Miguel Bernardes
  • Function : Author
Maria Margarida Cunha
  • Function : Author
Christof Specker
  • Function : Author
Viviane Angelina De Souza
  • Function : Author
Licia Maria Henrique Da Mota
  • Function : Author
Ana Paula Monteiro Gomides
  • Function : Author
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
Jonathan S Hausmann
  • Function : Author
Jean W Liew
  • Function : Author
Paul Sufka
  • Function : Author
Philip C Robinson
  • Function : Author
Pedro M Machado
  • Function : Author

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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Dates and versions

hal-03895851 , version 1 (30-04-2024)

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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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