RT Journal Article
SR Electronic
T1 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
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 1137
OP 1146
DO 10.1136/annrheumdis-2021-220418
VO 80
IS 9
A1 Jeffrey A Sparks
A1 Zachary S Wallace
A1 Andrea M Seet
A1 Milena A Gianfrancesco
A1 Zara Izadi
A1 Kimme L Hyrich
A1 Anja Strangfeld
A1 Laure Gossec
A1 Loreto Carmona
A1 Elsa F Mateus
A1 Saskia Lawson-Tovey
A1 Laura Trupin
A1 Stephanie Rush
A1 Patricia Katz
A1 Gabriela Schmajuk
A1 Lindsay Jacobsohn
A1 Leanna Wise
A1 Emily L Gilbert
A1 Ali Duarte-García
A1 Maria O Valenzuela-Almada
A1 Guillermo J Pons-Estel
A1 Carolina A Isnardi
A1 Guillermo A Berbotto
A1 Tiffany Y -T Hsu
A1 Kristin M D’Silva
A1 Naomi J Patel
A1 Lianne Kearsley-Fleet
A1 Martin Schäfer
A1 Sandra Lúcia Euzébio Ribeiro
A1 Samar Al Emadi
A1 Liselotte Tidblad
A1 Carlo Alberto Scirè
A1 Bernd Raffeiner
A1 Thierry Thomas
A1 René-Marc Flipo
A1 Jérôme Avouac
A1 Raphaèle Seror
A1 Miguel Bernardes
A1 Maria Margarida Cunha
A1 Rebecca Hasseli
A1 Hendrik Schulze-Koops
A1 Ulf Müller-Ladner
A1 Christof Specker
A1 Viviane Angelina de Souza
A1 Licia Maria Henrique da Mota
A1 Ana Paula Monteiro Gomides
A1 Philippe Dieudé
A1 Elena Nikiphorou
A1 Vanessa L Kronzer
A1 Namrata Singh
A1 Manuel F Ugarte-Gil
A1 Beth Wallace
A1 Akpabio Akpabio
A1 Ranjeny Thomas
A1 Suleman Bhana
A1 Wendy Costello
A1 Rebecca Grainger
A1 Jonathan S Hausmann
A1 Jean W Liew
A1 Emily Sirotich
A1 Paul Sufka
A1 Philip C Robinson
A1 Pedro M Machado
A1 Jinoos Yazdany
A1 ,
YR 2021
UL http://ard.bmj.com/content/80/9/1137.abstract
AB Objective To investigate baseline use of biologic or targeted synthetic (b/ts) disease-modifying antirheumatic drugs (DMARDs) and COVID-19 outcomes in rheumatoid arthritis (RA).Methods We analysed the COVID-19 Global Rheumatology Alliance physician registry (from 24 March 2020 to 12 April 2021). We investigated b/tsDMARD use for RA at the clinical onset of COVID-19 (baseline): abatacept (ABA), rituximab (RTX), Janus kinase inhibitors (JAKi), interleukin 6 inhibitors (IL-6i) or tumour necrosis factor inhibitors (TNFi, reference group). The ordinal COVID-19 severity outcome was (1) no hospitalisation, (2) hospitalisation without oxygen, (3) hospitalisation with oxygen/ventilation or (4) death. We used ordinal logistic regression to estimate the OR (odds of being one level higher on the ordinal outcome) for each drug class compared with TNFi, adjusting for potential baseline confounders.Results Of 2869 people with RA (mean age 56.7 years, 80.8% female) on b/tsDMARD at the onset of COVID-19, there were 237 on ABA, 364 on RTX, 317 on IL-6i, 563 on JAKi and 1388 on TNFi. Overall, 613 (21%) were hospitalised and 157 (5.5%) died. RTX (OR 4.15, 95% CI 3.16 to 5.44) and JAKi (OR 2.06, 95% CI 1.60 to 2.65) were each associated with worse COVID-19 severity compared with TNFi. There were no associations between ABA or IL6i and COVID-19 severity.Conclusions People with RA treated with RTX or JAKi had worse COVID-19 severity than those on TNFi. The strong association of RTX and JAKi use with poor COVID-19 outcomes highlights prioritisation of risk mitigation strategies for these people.Data are available upon reasonable request. Applications to access the data should be made to the C19-GRA Steering Committee.