Effect of IBD medications on COVID-19 outcomes: results from an international registry.
Gut
; 70(4): 725-732, 2021 04.
Article
in English
| MEDLINE | ID: covidwho-883380
ABSTRACT
OBJECTIVE:
We sought to evaluate COVID-19 clinical course in patients with IBD treated with different medication classes and combinations.DESIGN:
Surveillance Epidemiology of Coronavirus Under Research Exclusion for Inflammatory Bowel Disease (SECURE-IBD) is a large, international registry created to monitor outcomes of IBD patients with confirmed COVID-19. We used multivariable regression with a generalised estimating equation accounting for country as a random effect to analyse the association of different medication classes with severe COVID-19, defined as intensive care unit admission, ventilator use and/or death.RESULTS:
1439 cases from 47 countries were included (mean age 44.1 years, 51.4% men) of whom 112 patients (7.8%) had severe COVID-19. Compared with tumour necrosis factor (TNF) antagonist monotherapy, thiopurine monotherapy (adjusted OR (aOR) 4.08, 95% CI 1.73 to 9.61) and combination therapy with TNF antagonist and thiopurine (aOR 4.01, 95% CI 1.65 to 9.78) were associated with an increased risk of severe COVID-19. Any mesalamine/sulfasalazine compared with no mesalamine/sulfasalazine use was associated with an increased risk (aOR 1.70, 95% CI 1.26 to 2.29). This risk estimate increased when using TNF antagonist monotherapy as a reference group (aOR 3.52, 95% CI 1.93 to 6.45). Interleukin-12/23 and integrin antagonists were not associated with significantly different risk than TNF antagonist monotherapy (aOR 0.98, 95% CI 0.12 to 8.06 and aOR 2.42, 95% CI 0.59 to 9.96, respectively).CONCLUSION:
Combination therapy and thiopurines may be associated with an increased risk of severe COVID-19. No significant differences were observed when comparing classes of biologicals. These findings warrant confirmation in large population-based cohorts.MKH should be changed to MDK for co-last author line.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Azathioprine
/
Inflammatory Bowel Diseases
/
Tumor Necrosis Factor Inhibitors
/
SARS-CoV-2
/
COVID-19
/
Mercaptopurine
Type of study:
Cohort study
/
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Adult
/
Female
/
Humans
/
Male
Language:
English
Journal:
Gut
Year:
2021
Document Type:
Article
Affiliation country:
Gutjnl-2020-322539
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