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Incidence of COVID-19 in patients treated with infliximab compared with patients treated with rituximab.
Melong Pianta Taleng, Cathy Mireille; Lauper, Kim; Gilbert, Benoit; Cunningham, Tim; Guemara, Romain; Brulhart, Laure; Dan, Diana; Courvoisier, Delphine; Finckh, Axel.
Afiliación
  • Melong Pianta Taleng CM; Divison of Rheumatology, Department of Internal Medicine, Geneva University Hospitals, Geneve, Switzerland.
  • Lauper K; Division of Rheumatology, Yaounde University Hospital, Yaounde, Cameroon.
  • Gilbert B; Divison of Rheumatology, Department of Internal Medicine, Geneva University Hospitals, Geneve, Switzerland.
  • Cunningham T; The University of Manchester Centre for Musculoskeletal Research, Manchester, UK.
  • Guemara R; Divison of Rheumatology, Department of Internal Medicine, Geneva University Hospitals, Geneve, Switzerland.
  • Brulhart L; Rheumatology, Private Practice, Geneva, Switzerland.
  • Dan D; Rheumatology, Network Hospital Neuchâtel, Neuchatel, Switzerland.
  • Courvoisier D; Rheumatology, Network Hospital Neuchâtel, Neuchatel, Switzerland.
  • Finckh A; Division of Rheumatology, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
RMD Open ; 7(3)2021 12.
Article en En | MEDLINE | ID: mdl-34862310
OBJECTIVE: To determine whether patients with inflammatory autoimmune diseases treated with rituximab (RTX) have more severe forms of COVID-19 compared with patients treated with anticytokine therapies, such as Tumour Necrosis Factor (TNF) inhibitors. METHODS: We included all patients who were on either RTX or infliximab (IFX) in two Swiss cantons during the first wave of the COVID-19 pandemic. We collected self-reported symptoms compatible with COVID-19, PCR-confirmed diagnoses of COVID-19 and the evolution of COVID-19 infections. We computed the raw and propensity score-adjusted incidence of COVID-19 by treatment group. RESULTS: 190 patients were enrolled, of whom 121 (64%) were in the RTX group and 69 (36%) were in the IFX group. Twenty-one patients (11%) reported symptoms compatible with COVID-19 (RTX: 10, IFX: 11, p=0.14). Among patients with COVID-19 symptoms, four developed severe forms of the disease, with life-threatening pulmonary manifestations requiring intensive mechanical ventilation (RTX: 4 of 10, IFX: 0 of 11, Fisher's exact test p=0.04). The incidence rate of COVID-19 symptoms was 0.73 (95% CI 0.39 to 1.37) cases per 1000 patient-days on RTX vs 1.52 (95% CI 0.82 to 2.85) cases per 1000 patient-days on IFX (crude p=0.10, adjusted p=0.07). The incidence rate of severe COVID-19 was 0.28 (95% CI 0.08 to 0.7.2) cases per 1000 patient-days on RTX compared with null on IFX (95% CI 0.0 to 0.44) (p=0.13). A replication in an independent validation cohort confirmed these findings, with consistent results in the Swiss Clinical Quality Management registry. CONCLUSION: While the incidence of symptoms compatible with COVID-19 was overall similar in patients receiving RTX or IFX, the incidence of severe COVID-19 tended to be higher in the RTX group.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artritis Reumatoide / Antirreumáticos / COVID-19 Tipo de estudio: Incidence_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: RMD Open Año: 2021 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artritis Reumatoide / Antirreumáticos / COVID-19 Tipo de estudio: Incidence_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: RMD Open Año: 2021 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Reino Unido