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Role of targeted therapies in rheumatic patients on COVID-19 outcomes: results from the COVIDSER study.
Álvaro Gracia, Jose María; Sanchez-Piedra, Carlos; Manero, Javier; Ruiz-Lucea, María Ester; López-Vives, Laura; Bohorquez, Cristina; Martinez-Barrio, Julia; Bonilla, Gema; Vela, Paloma; García-Villanueva, María Jesús; Navío-Marco, María Teresa; Pavía, Marina; Galindo, María; Erausquin, Celia; Gonzalez-Gay, Miguel A; Rua-Figueroa, Inigo; Pego-Reigosa, Jose M; Castrejon, Isabel; Sanchez-Costa, Jesús T; González-Dávila, Enrique; Diaz-Gonzalez, Federico.
  • Álvaro Gracia JM; Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
  • Sanchez-Piedra C; Research Unit, Sociedad Española de Reumatología, Madrid, Spain.
  • Manero J; Rheumatology Department, Hospital Universitario Miguel Servet, Zaragoza, Aragón, Spain.
  • Ruiz-Lucea ME; Rheumatology Department, Hospital Universitario Basurto, Bilbao, País Vasco, Spain.
  • López-Vives L; Rheumatology Department, Hospital San Rafael, Barcelona, Catalunya, Spain.
  • Bohorquez C; Department of Rheumatology, Hospital Universitario Príncipe de Asturias, Alcala de Henares, Madrid, Spain.
  • Martinez-Barrio J; Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
  • Bonilla G; Department of Rheumatology, La Paz University Hospital, Madrid, Spain.
  • Vela P; Department of Rheumatology, Hospital General Universitario de Alicante, Alicante, Spain.
  • García-Villanueva MJ; Department of Rheumatology, Hospital Universitario Ramon y Cajal, Madrid, Madrid, Spain.
  • Navío-Marco MT; Department of Rheumatology, Hospital Universitario Infanta Leonor, Madrid, Spain.
  • Pavía M; Department of Rheumatology, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Comunidad de Madrid, Spain.
  • Galindo M; Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid, Comunidad de Madrid, Spain.
  • Erausquin C; Department of Rheumatology, Hospital Doctor Negrin, Las Palmas GC, Spain.
  • Gonzalez-Gay MA; Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain.
  • Rua-Figueroa I; Department of Rheumatology, Hospital Doctor Negrin, Las Palmas GC, Spain.
  • Pego-Reigosa JM; Department of Rheumatology, University Hospital Complex of Vigo, Vigo, Spain.
  • Castrejon I; Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
  • Sanchez-Costa JT; Research Unit, Sociedad Española de Reumatología, Madrid, Spain.
  • González-Dávila E; Departamento de Estadística e Investigación Operativa, Universidad de La Laguna, La Laguna, Islas Canarias, Spain.
  • Diaz-Gonzalez F; Department of Rheumatology, Hospital Universitario de Canarias, La Laguna, Spain federico.diaz.gonzalez@gmail.com.
RMD Open ; 7(3)2021 12.
Article in English | MEDLINE | ID: covidwho-1566378
ABSTRACT

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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Rheumatic Diseases / Antirheumatic Agents / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Humans / Male Language: English Year: 2021 Document Type: Article Affiliation country: Rmdopen-2021-001925

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Rheumatic Diseases / Antirheumatic Agents / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Humans / Male Language: English Year: 2021 Document Type: Article Affiliation country: Rmdopen-2021-001925