RT Journal Article
SR Electronic
T1 Use of non-steroidal anti-inflammatory drugs and risk of death from COVID-19: an OpenSAFELY cohort analysis based on two cohorts
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP annrheumdis-2020-219517
DO 10.1136/annrheumdis-2020-219517
A1 Wong, Angel YS
A1 MacKenna, Brian
A1 Morton, Caroline E
A1 Schultze, Anna
A1 Walker, Alex J
A1 Bhaskaran, Krishnan
A1 Brown, Jeremy P
A1 Rentsch, Christopher T
A1 Williamson, Elizabeth
A1 Drysdale, Henry
A1 Croker, Richard
A1 Bacon, Seb
A1 Hulme, William
A1 Bates, Chris
A1 Curtis, Helen J
A1 Mehrkar, Amir
A1 Evans, David
A1 Inglesby, Peter
A1 Cockburn, Jonathan
A1 McDonald, Helen I
A1 Tomlinson, Laurie
A1 Mathur, Rohini
A1 Wing, Kevin
A1 Forbes, Harriet
A1 Eggo, Rosalind M
A1 Parry, John
A1 Hester, Frank
A1 Harper, Sam
A1 Evans, Stephen JW
A1 Smeeth, Liam
A1 Douglas, Ian J
A1 Goldacre, Ben
YR 2021
UL http://ard.bmj.com/content/early/2021/01/20/annrheumdis-2020-219517.abstract
AB Objectives To assess the association between routinely prescribed non-steroidal anti-inflammatory drugs (NSAIDs) and deaths from COVID-19 using OpenSAFELY, a secure analytical platform.Methods We conducted two cohort studies from 1 March to 14 June 2020. Working on behalf of National Health Service England, we used routine clinical data in England linked to death data. In study 1, we identified people with an NSAID prescription in the last 3 years from the general population. In study 2, we identified people with rheumatoid arthritis/osteoarthritis. We defined exposure as current NSAID prescription within the 4 months before 1 March 2020. We used Cox regression to estimate HRs for COVID-19 related death in people currently prescribed NSAIDs, compared with those not currently prescribed NSAIDs, accounting for age, sex, comorbidities, other medications and geographical region.Results In study 1, we included 536 423 current NSAID users and 1 927 284 non-users in the general population. We observed no evidence of difference in risk of COVID-19 related death associated with current use (HR 0.96, 95% CI 0.80 to 1.14) in the multivariable-adjusted model. In study 2, we included 1 708 781 people with rheumatoid arthritis/osteoarthritis, of whom 175 495 (10%) were current NSAID users. In the multivariable-adjusted model, we observed a lower risk of COVID-19 related death (HR 0.78, 95% CI 0.64 to 0.94) associated with current use of NSAID versus non-use.Conclusions We found no evidence of a harmful effect of routinely prescribed NSAIDs on COVID-19 related deaths. Risks of COVID-19 do not need to influence decisions about the routine therapeutic use of NSAIDs.