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Incidence and severeness of COVID-19 hospitalization in patients with inflammatory rheumatic disease: a nationwide cohort study from Denmark

RHEUMATOLOGY (2021)

期刊

RHEUMATOLOGY

卷 60, 期 -, 页码 SI59-SI67

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OXFORD UNIV PRESS

DOI: 10.1093/rheumatology/keaa897

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rheumatoid arthritis; epidemiology; viruses; DMARDs; biological therapies; immunosupressants

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Rheumatology

资金

Aalborg University Hospital, Denmark

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The study found that patients with inflammatory rheumatic diseases (IRD) were more likely to be hospitalized with COVID-19, while treatment with specific DMARDs did not affect the risk of hospitalization for RA patients, but could increase the risk of severe outcomes.

Objectives. To estimate the incidence of COVID-19 hospitalization in patients with inflammatory rheumatic disease (IRD); in patients with RA treated with specific DMARDs; and the incidence of severe COVID-19 infection among hospitalized patients with RA. Methods. A nationwide cohort study from Denmark between 1 March and 12 August 2020. The adjusted incidence of COVID-19 hospitalization was estimated for patients with RA; spondyloarthritis including psoriatic arthritis; connective tissue disease; vasculitides; and non-IRD individuals. Further, the incidence of COVID-19 hospitalization was estimated for patients with RA treated and non-treated with TNF-inhibitors, HCQ or glucocorticoids, respectively. Lastly, the incidence of severe COVID-19 infection (intensive care, acute respiratory distress syndrome or death) among hospital-admitted patients was estimated for RA and non-IRD sp - individudals. Results. Patients with IRD (n=58 052) had an increased partially adjusted incidence of hospitalization with COVID-19 compared with the 4.5 million people in the general population [hazard ratio (HR) 1.46, 95% CI: 1.15, 1.86] with strongest associations for patients with RA (n=29 440, HR 1.72, 95% CI: 1.29, 2.30) and vasculitides (n=4072, HR 1.82, 95% CI: 0.91, 3.64). There was no increased incidence of COVID-19 hospitalization associated with TNF-inhibitor, HCQ nor glucocorticoid use. COVID-19 admitted patients with RA had a HR of 1.43 (95% CI: 0.80, 2.53) for a severe outcome. Conclusion. Patients with IRD were more likely to be admitted with COVID-19 than the general population, and COVID-19 admitted patients with RA could be at higher risk of a severe outcome. Treatment with specific DMARDs did not affect the risk of hospitalization.

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Safety of synthetic and biological DMARDs: a systematic literature review informing the 2022 update of the EULAR recommendations for the management of rheumatoid arthritis

Alexandre Sepriano, Andreas Kerschbaumer, Sytske Anne Bergstra, Josef S. Smolen, Desiree van der Heijde, Roberto Caporali, Christopher J. Edwards, Patrick Verschueren, Savia de Souza, Janet Pope, Tsutomu Takeuchi, Kimme Hyrich, Kevin L. Winthrop, Daniel Aletaha, Tanja Stamm, Jan W. Schoones, Robert B. M. Landewe

Summary: This study conducted a systematic literature review (SLR) to evaluate the safety of synthetic and biological disease-modifying antirheumatic drugs (DMARDs) for the management of rheumatoid arthritis (RA). The results indicated that bDMARDs were associated with an increased risk of serious infections compared to csDMARDs, while JAK inhibitors (JAKi) showed higher risk of herpes zoster infections. The risks of malignancies, major adverse cardiovascular events (MACE), and venous thromboembolism (VTE) were similar among different treatments.

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