Role of targeted therapies in rheumatic patients on COVID-19 outcomes: results from the COVIDSER study

Abstract

ObjectivesTo analyse the effect of targeted therapies, either biological (b) disease-modifying antirheumatic drugs (DMARDs), targeted synthetic (ts) DMARDs and other factors (demographics, comorbidities or COVID-19 symptoms) on the risk of COVID-19 related hospitalisation in patients with inflammatory rheumatic diseases.MethodsThe COVIDSER study is an observational cohort including 7782 patients with inflammatory rheumatic diseases. Multivariable logistic regression was used to estimate ORs and 95% CIs of hospitalisation. Antirheumatic medication taken immediately prior to infection, demographic characteristics, rheumatic disease diagnosis, comorbidities and COVID-19 symptoms were analysed.ResultsA total of 426 cases of symptomatic COVID-19 from 1 March 2020 to 13 April 2021 were included in the analyses: 106 (24.9%) were hospitalised and 19 (4.4%) died. In multivariate-adjusted models, bDMARDs and tsDMARDs in combination were not associated with hospitalisation compared with conventional synthetic DMARDs (OR 0.55, 95% CI 0.24 to 1.25 of b/tsDMARDs, p=0.15). Tumour necrosis factor inhibitors (TNF-i) were associated with a reduced likelihood of hospitalisation (OR 0.32, 95% CI 0.12 to 0.82, p=0.018), whereas rituximab showed a tendency to an increased risk of hospitalisation (OR 4.85, 95% CI 0.86 to 27.2). Glucocorticoid use was not associated with hospitalisation (OR 1.69, 95% CI 0.81 to 3.55). A mix of sociodemographic factors, comorbidities and COVID-19 symptoms contribute to patients’ hospitalisation.ConclusionsThe use of targeted therapies as a group is not associated with COVID-19 severity, except for rituximab, which shows a trend towards an increased risk of hospitalisation, while TNF-i was associated with decreased odds of hospitalisation in patients with rheumatic disease. Other factors like age, male gender, comorbidities and COVID-19 symptoms do play a role.

Factors influencing the course of COVID-19 in the inflammatory rheumatic diseases

“…Fever (67% vs. 57%), cough (57% vs. 42%), dyspnea (34% vs. 20%), myalgia (76% vs. 62%), loss of taste and smell (54% vs. 21%), and lung involvement (28% vs. 14%) were found to be significantly lower in the omicron period patients (p<0.05 for all). Our results are in line with previous studies on this subject (3)(4)(5)(6)(7)(8)(9). Santos et al from Spain, reported the presence of rheumatic disease activity, dyslipidaemia, and cardiovascular disease as risk factors for mortality in a study they conducted in the first months of the pandemic (3).…”

An update on COVID-19 in paediatric and young adults with nephrotic syndrome, receiving chronic immunosuppression during the Omicron pandemic

“…According to our observation, vaccination appears to be the greatest protective factor towards COVID-19. Unlike previous reports in the context of rheumatic diseases [ 5 ], no major or fatal COVID-19-related complications were reported in our patients receiving rituximab: our therapeutic scheme is limited to a single infusion of 375 mg/m 2 and this strategy may protect against severe complications.…”

Effects of COVID-19 vaccination on disease activity in patients with rheumatoid arthritis and psoriatic arthritis on targeted therapy in the COVIDSER study

“…The COVIDSER study is an observational cohort of patients from three Spanish database registries which included patients with rheumatic diseases: BIOBADASER III, CARMA and RELESSER, all promoted by the Spanish Society of Rheumatology. 15 In this study, only patients from BIOBADASER III were included. BIOBADASER is a Spanish multicentre observational registry used to assess safety in patients with rheumatic diseases who start treatment with any targeted therapy, including bDMARDs, biosimilars or tsDMARDs.…”

“…The COVIDSER study is an observational cohort of patients from three Spanish database registries which included patients with rheumatic diseases: BIOBADASER III, CARMA and RELESSER, all promoted by the Spanish Society of Rheumatology 15. In this study, only patients from BIOBADASER III were included.…”