Background Various observations have suggested that the course of COVID-19 might be less favourable in patients with inflammatory rheumatic and musculoskeletal diseases receiving rituximab compared with those not receiving rituximab. We aimed to investigate whether treatment with rituximab is associated with severe COVID-19 outcomes in patients with inflammatory rheumatic and musculoskeletal diseases.Methods In this cohort study, we analysed data from the French RMD COVID-19 cohort, which included patients aged 18 years or older with inflammatory rheumatic and musculoskeletal diseases and highly suspected or confirmed COVID-19. The primary endpoint was the severity of COVID-19 in patients treated with rituximab (rituximab group) compared with patients who did not receive rituximab (no rituximab group). Severe disease was defined as that requiring admission to an intensive care unit or leading to death. Secondary objectives were to analyse deaths and duration of hospital stay. The inverse probability of treatment weighting propensity score method was used to adjust for potential confounding factors (age, sex, arterial hypertension, diabetes, smoking status, body-mass index, interstitial lung disease, cardiovascular diseases, cancer, corticosteroid use, chronic renal failure, and the underlying disease [rheumatoid arthritis vs others]). Odds ratios and hazard ratios and their 95% CIs were calculated as effect size, by dividing the two population mean differences by their SD. This study is registered with ClinicalTrials.gov, NCT04353609.

Both the SF-36 and LupusQoL were responsive to changes in QoL in SLE patients over a 3 month interval. LupusQoL seems to be more appropriate to measure improvements in QoL.

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IntroductionImmune thrombocytopenia (ITP) is an autoimmune disease characterized by low platelet counts due to increased destruction and impaired platelet production, partially related to the presence of autoantibodies directed toward platelet-membrane antigens. 1 ITP manifestations include various degrees of cutaneous and/or mucosal purpura; life-threatening hemorrhages occur in less than 5% of adult patients. 2 Onset is frequently insidious and low platelet counts often last beyond 6 months. 3 In adults, the incidence of ITP is approximately 3.3 per 100 000 person-years. 4,5 Studies have suggested that immunizations could be involved in the development of autoimmune disorders. 6 This could be because of molecular mimicry, in which antigens of the host are recognized as being similar to antigens of the immunization, thus provoking the development of autoantibodies. 7,8 Although several populationbased studies have described an association between the measlesmumps-rubella vaccine and ITP in children, 9-12 published evidence concerning the risk associated with other vaccines or with vaccination in adults is sparse and limited to a few case reports. [13][14][15][16][17] The risk of ITP associated with adult vaccines therefore remains controversial. The objective of this prospective case-control study was to explore the incidence of ITP in relation to all vaccination in adults, with a special emphasis on vaccines against influenza (the injectable/killed type only) and diphtheria-tetanus-pertussispoliomyelitis (DTPP). Methods PatientsThis case-control study prospectively recruited consecutive patients with newly diagnosed ITP at 22 internal medicine and hematology centers in continental France and compared them with controls recruited from general practice settings. Cases and controls were recruited from the same geographically diverse areas. All participants (cases and controls) provided informed written consent to participate in the study, were 18-79 years of age, could read French, and were capable of answering questions by a The online version of this article contains a data supplement.The publication costs of this article were defrayed in part by page charge payment. Therefore, and solely to indicate this fact, this article is hereby marked ''advertisement'' in accordance with 18 USC section 1734. For personal use only. on May 11, 2018. by guest www.bloodjournal.org From qualified telephone interviewer. Cases and controls were excluded from the study if they had a history of thrombocytopenia.The study protocol was submitted to the ethical review committee of Paris-Ile de France III (Comité de Protection des Personnes Ile de France III) and was approved by the French Data Protection Authority (Commission Nationale de l'Informatique et des Libertés). All participants signed an informed consent form in accordance with the Declaration of Helsinki. Study populationCase subjects. We conducted this study using patient data retrieved from the Pharmacoepidemiological General Research on ITP (PGRx-ITP) registry, a French...