COVID-19 Incidence in Patients With Immunomediated Inflammatory Diseases: Influence of Immunosuppressant Treatments.

Autor:	Soldevila-Domenech N; Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.; Department of Experimental and Health Sciences, Universitat Pompeu Fabra (CEXS-UPF), Barcelona, Spain., Tío L; IMIM (Hospital Del Mar Medical Research Institute), PRBB, Barcelona, Spain., Llorente-Onaindia J; IMIM (Hospital Del Mar Medical Research Institute), PRBB, Barcelona, Spain., Martín-García E; IMIM (Hospital Del Mar Medical Research Institute), PRBB, Barcelona, Spain.; Laboratory of Neuropharmacology, Department of Experimental and Health Sciences, Universitat Pompeu Fabra, PRBB, Barcelona, Spain., Nebot P; Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.; IMIM (Hospital Del Mar Medical Research Institute), PRBB, Barcelona, Spain., de la Torre R; Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.; Department of Experimental and Health Sciences, Universitat Pompeu Fabra (CEXS-UPF), Barcelona, Spain.; Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain., Gurt A; CAP Vila Olímpica, Parc Sanitari Pere Virgili, Barcelona, Spain., Maldonado R; IMIM (Hospital Del Mar Medical Research Institute), PRBB, Barcelona, Spain.; Laboratory of Neuropharmacology, Department of Experimental and Health Sciences, Universitat Pompeu Fabra, PRBB, Barcelona, Spain., Monfort J; IMIM (Hospital Del Mar Medical Research Institute), PRBB, Barcelona, Spain.; Rheumatology Service, Hospital del Mar, Barcelona, Spain.
Jazyk:	angličtina
Zdroj:	Frontiers in pharmacology [Front Pharmacol] 2020 Dec 21; Vol. 11, pp. 583260. Date of Electronic Publication: 2020 Dec 21 (Print Publication: 2020).
DOI:	10.3389/fphar.2020.583260
Abstrakt:	The effect of immunosuppressant treatments on the incidence of coronavirus disease (COVID-19) remains largely unknown. We studied the association between the pre-exposure to disease-modifying antirheumatic drugs (DMARDs) that decrease immunological responses and the incidence of COVID-19 to explore the possible effects of these treatments in early manifestations of the disease. For this purpose, we performed a cross-sectional study including 2,494 patients with immunomediated inflammatory diseases (IMIDs) recruited at the outpatient Rheumatology, Dermatology and Gastroenterology services of Hospital del Mar. The primary outcome was the clinical diagnosis of COVID-19 performed by a physician at the hospital or at the primary care center, from the March 1-29, 2020. Multivariable Poisson regression models were fitted to estimate COVID-19 relative risk (RR) adjusted by comorbidities. We revealed that biological (RR = 0.46, CI 95% = 0.31-0.67) and synthetic (RR = 0.62, CI 95% = 0.43-0.91) DMARDs used in IMIDs diminished the incidence of COVID-19. Striking sex differences were revealed with anti-TNFα compounds (RR = 0.50, CI 95% = 0.33-0.75) with higher effects in women (RR = 0.33, CI 95% = 0.17-0.647). Treatment with low glucocorticoid doses also revealed sex differences decreasing the incidence of COVID-19 predominantly in women (RR = 0.72, CI 95% = 0.42-1.22). Our results report a decreased incidence of COVID-19 in patients receiving specific DMARDs with different immunodepressor mechanisms with striking sex differences. These results underline the interest of repurposing specific DMARDs for the possibility of minimizing the severity of disease progression in the early stages of COVID-19. Competing Interests: AG has received research grants or consulting fees from Astrazeneca and Bioiberica S.A.U., RM has received research grants or consulting fees from Aelis, Almirall, Boehringer Ingelheim, BrainCo, Esteve, Ferrer, GlaxoSmithKline, Grünenthal, GW Pharmaceuticals, Janus, Lundbeck, Pharmaleads, Phytoplant, Rhodes, Sanofi, Spherium, Union de Pharmacologie Scientifique Appliquée, Upjohn, and Uriach; JM has received grants or consulting fees from Procare Health Iberia S.L, Esteve, Labhra, Bioibérica S.A.U, Grunenthal Pharma S.A, Pfizer, OPKO Heath Spain S.L.U and Roche Pharma S.A. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2020 Soldevila-Domenech, Tío, Llorente‐Onaindia, Martín‐García, Nebot, de la Torre, Gurt, Maldonado and Monfort.)
Databáze:	MEDLINE
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