Risk of COVID-19 hospitalization and mortality in rheumatic patients treated with hydroxychloroquine or other conventional DMARDs in Italy
| Autor: | Alegiani, Stefania Spila, Crisafulli, Salvatore, Rossi, Paolo Giorgi, Mancuso, Pamela, Salvarani, Carlo, Atzeni, Fabiola, Gini, Rosa, Kirchmayer, Ursula, Belleudi, Valeria, Kurotschka, Peter Konstantin, Leoni, Olivia, Ludergnani, Monica, Ferroni, Eliana, Baracco, Susanna, Massari, Marco, Trifirò, Gianluca, ITA-COVID-19, Network |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Adolescent Young Adult Rheumatic Diseases Odds Ratio Humans Glucocorticoids AcademicSubjects/MED00360 Aged Aged 80 and over SARS-CoV-2 Antirheumatic agents COVID-19 Chloroquine Hydroxychloroquine outpatients Middle Aged COVID-19 Drug Treatment Hospitalization Italy Case-Control Studies Population Surveillance Original Article Drug Therapy Combination Female |
| Zdroj: | Rheumatology (Oxford, England) |
| ISSN: | 1462-0332 1462-0324 |
| Popis: | Objectives To ascertain if hydroxychloroquine (HCQ)/chloroquine (CLQ) and other conventional disease-modifying anti-rheumatic drugs (cDMARDs) use, and rheumatic diseases per se, may be associated with COVID-19-related risk of hospitalization and mortality. Methods This case-control study nested within a cohort of cDMARD users was conducted in the Lombardy, Veneto, Tuscany and Lazio regions and Reggio Emilia province. Claims databases were linked to COVID-19 surveillance registries. Risk of COVID-19-related outcomes was estimated using a multivariate conditional logistic regression analysis, comparing HCQ/CLQ vs methotrexate, vs other cDMARDs and vs non-use of these drugs. Presence of rheumatic diseases vs their absence in a non-nested population was investigated. Results 1275 cases hospitalized due to COVID-19 were matched to 12 734 controls. Compared with recent use of methotrexate, no association between HCQ/CLQ monotherapy and COVID-19 hospitalization (OR 0.83 [95%CI, 0.69–1.00]) or mortality (OR 1.19 [95%CI, 0.85–1.67]) was observed. A lower risk was found when comparing HCQ/CLQ use to the concomitant use of other cDMARDs and glucocorticoids. HCQ/CLQ was not associated with COVID-19 hospitalization as compared with non-use. An increased risk for recent use of either methotrexate monotherapy (OR 1.19 [95% CI, 1.05–1.34]) or other cDMARDs (OR 1.21 [95% CI, 1.08–1.36]) vs non-use was found. Rheumatic diseases were not associated with COVID-19-related outcomes. Conclusion HCQ/CLQ use in rheumatic patients was not associated with a protective effect against COVID-19-related outcomes. Use of other cDMARDs was associated with an increased risk when compared with non-use, and, if concomitantly used with glucocorticoids, also vs HCQ/CLQ, probably to be ascribed to immunosuppressive action. |
| Databáze: | OpenAIRE |
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