Results of primary and sensitivity analyses investigating the associations of baseline use of biologic or targeted synthetic disease-modifying antirheumatic drugs with COVID-19 severity (N=2869)
| Abatacept | Rituximab | IL-6i | JAKi | TNFi | |||||
| OR (95% CI) | P value | OR (95% CI) | P value | OR (95% CI) | P value | OR (95% CI) | P value | Ref | |
| Unadjusted | 1.88 (1.35 to 2.63) | <0.01 | 4.63 (3.60 to 5.96) | <0.01 | 1.00 (0.71 to 1.41) | 0.99 | 2.28 (1.80 to 2.88) | <0.01 | Ref |
| Age-adjusted and sex-adjusted | 1.40 (0.99 to 1.99) | 0.06 | 4.45 (3.43 to 5.77) | <0.01 | 1.06 (0.68 to 1.37) | 0.84 | 2.10 (1.64 to 2.68) | <0.01 | Ref |
| Multivariable-adjusted (primary analysis) | 1.26 (0.88 to 1.80) | 0.21 | 4.15 (3.16 to 5.44) | <0.01 | 0.81 (0.56 to 1.18) | 0.55 | 2.06 (1.60 to 2.65) | <0.01 | Ref |
| Confirmed cases only* | 1.14 (0.77 to 1.68) | 0.52 | 4.25 (3.17 to 5.69) | <0.01 | 0.74 (0.49 to 1.11) | 0.15 | 2.05 (1.57 to 2.69) | <0.01 | Ref |
| Excluding patients with ILD or cancer† | 1.18 (0.79 to 1.76) | 0.43 | 4.34 (3.23 to 5.82) | <0.01 | 0.81 (0.54 to 1.21) | 0.30 | 2.14 (1.64 to 2.79) | <0.01 | Ref |
| Restricted to USA and additionally adjusted for race‡ | 1.16 (0.79 to 1.69) | 0.45 | 4.77 (3.57 to 6.38) | <0.01† | ¶ | ¶ | 2.86 (1.76 to 4.65) | <0.01† | Ref |
| Propensity score-matched§ | 1.60 (1.02 to 2.51) | 0.04 | 4.70 (3.31 to 6.65) | <0.01 | 0.76 (0.46 to 1.23) | 0.26 | 2.09 (1.50 to 2.90) | <0.01 | Ref |
The effect size is the odds of being one level higher on the ordinal COVID-19 severity scale than the reference group (TNFi users).
Adjusted for age, sex, region, calendar time, obesity, smoking, concomitant csDMARD use, glucocorticoid use/dose, comorbidity count, hypertension/cardiovascular disease, interstitial lung disease, cancer and rheumatoid arthritis disease activity except as otherwise indicated.
*n=2333 in the analysis analysing only confirmed COVID-19 cases.
†n=2704 in the analysis excluding ILD and cancer.
‡n=868 in the USA-only analysis.
§n for each pair of propensity score-matched analyses: abatacept: 236, TNFi: 1376; rituximab: 364, TNFi: 1382; IL-6i: 313, TNFi: 1387; JAKi: 560, TNFi: 1379.
¶Due to the small number of events in the covariate of race, the IL-6i model could not be analysed.
csDMARDs, conventional synthetic disease-modifying antirheumatic drugs; ILD, interstitial lung disease; IL6i, interleukin 6 inhibitor; JAKi, Janus kinase inhibitor; Ref, reference; TNFi, tumour necrosis factor inhibitors.