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OpenSAFELY: Do adults prescribed Non-steroidal anti-inflammatory drugs have an increased risk of death from COVID-19? (preprint)
medrxiv; 2020.
Preprint
Dans Anglais
| medRxiv | ID: ppzbmed-10.1101.2020.08.12.20171405
ABSTRACT
Importance There has been speculation that non-steroidal anti-inflammatory drugs (NSAIDs) may negatively affect coronavirus disease 2019 (COVID-19) outcomes, yet clinical evidence is limited. Objective:
To assess the association between NSAID use and deaths from COVID-19 using OpenSAFELY, a secure analytical platform.Design:
Two cohort studies (1st March-14th June 2020).Setting:
Working on behalf of NHS England, we used routine clinical data from >17 million patients in England linked to death data from the Office for National Statistics.Participants:
Study 1 General population (people with an NSAID prescription in the last three years). Study 2 people with rheumatoid arthritis/osteoarthritis. Exposures Current NSAID prescription within the 4 months before 1st March 2020. Main Outcome andMeasure:
We used Cox regression to estimate hazard ratios (HRs) for COVID-19 related death in people currently prescribed NSAIDs, compared with those not currently prescribed NSAIDs, adjusting for age, sex, comorbidities and other medications.Results:
In Study 1, we included 535,519 current NSAID users and 1,924,095 non-users in the general population. The crude HR for current use was 1.25 (95% CI, 1.07-1.46), versus non-use. We observed no evidence of difference in risk of COVID-19 related death associated with current use (HR, 0.95, 95% CI, 0.80-1.13) in the fully adjusted model. In Study 2, we included 1,711,052 people with rheumatoid arthritis/osteoarthritis, of whom 175,631 (10%) were current NSAID users. The crude HR for current use was 0.43 (95% CI, 0.36-0.52), versus non-use. In the fully adjusted model, we observed a lower risk of COVID-19 related death (HR, 0.78, 95% CI, 0.65-0.94) associated with current use of NSAID versus non-use. Conclusion and Relevance We found no evidence of a harmful effect of NSAIDs on COVID-19 related deaths. Risks from COVID-19 do not need to influence decisions about therapeutic use of NSAIDs.
Texte intégral:
Disponible
Collection:
Preprints
Base de données:
medRxiv
Sujet Principal:
Arthrose
/
Polyarthrite rhumatoïde
/
COVID-19
langue:
Anglais
Année:
2020
Type de document:
Preprint
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