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Correspondence
Correspondence on “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” by Sparks et al
  1. Elisa Gremese1,2,
  2. Gianfranco Ferraccioli3
  1. 1Division of Rheumatology, Università Cattolica del Sacro Cuore Facoltà di Medicina e Chirurgia, Roma, Lazio, Italy
  2. 2Institute of Rheumatology, Università Cattolica del Sacro Cuore Facoltà di Medicina e Chirurgia, Roma, Lazio, Italy
  3. 3Università Cattolica del Sacro Cuore Facoltà di Medicina e Chirurgia, Roma, Lazio, Italy
  1. Correspondence to Professor Elisa Gremese, Division of Rheumatology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Roma 00168, Lazio, Italy; elisa.gremese{at}unicatt.it

http://dx.doi.org/10.1136/annrheumdis-2021-220932

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    We read with great interest the Global Rheumatology Alliance report on COVID-19 on biologic or targeted synthetic disease-modifying antirheumatic drugs (DMARDs) in rheumatoid arthritis (RA).1 The first important result of the registry database is that B-cell depletion, by compromising the primary antibody response, increases the severity of infected patients. Considering the critical role of B cells in the adaptive immune response, this sounds quite correct.2 Even the data on interleukin 6 and tumour necrosis factor (TNF) inhibitors appear quite understandable considering the systemic inflammation raised by SARS-CoV-2 infection, the results of the Randomised Embedded Multifactorial Adaptive Platform for Community-acquired Pneumonia (REMAP-CAP) trial in patients on National Institute of Allergy and Infectious Diseases ordinal scale (NIAID)-Ordinal Scale 6 and 73 and the demonstrated role of TNF–TNF receptor 1 in inducing lymphopenia and T-cell dysfunction in severe–critical disease.4 Importantly, the death rate in abatacept was found close to that in JAK inhibitors. …

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    Footnotes

    • Contributors EG: Substantial contribution to study concept, drafted the paper for its intellectual content and approved the version of the submitted article. GF: Conceptualized the study, drafted the paper and approved the final version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; internally peer reviewed.

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