PMID- 35549809
OWN - NLM
STAT- MEDLINE
DCOM- 20230614
LR  - 20230615
IS  - 1502-7732 (Electronic)
IS  - 0300-9742 (Linking)
VI  - 52
IP  - 4
DP  - 2023 Jul
TI  - Risk of severe COVID-19 in patients with inflammatory rheumatic diseases treated 
      with immunosuppressive therapy in Scotland.
PG  - 412-417
LID - 10.1080/03009742.2022.2063376 [doi]
AB  - OBJECTIVE: To investigate the association of severe coronavirus disease 2019 
      (COVID-19) in patients with inflammatory rheumatic diseases (IRDs) treated with 
      immunosuppressive drugs. METHOD: A list of 4633 patients on targeted - biological 
      or targeted synthetic - DMARDs in March 2020 was linked to a case-control study 
      that includes all cases of COVID-19 in Scotland. RESULTS: By 22 November 2021, 
      433 of the 4633 patients treated with targeted DMARDS had been diagnosed with 
      COVID-19, of whom 58 had been hospitalized. With all those in the population not 
      on DMARDs as the reference category, the rate ratio for hospitalized COVID-19 
      associated with DMARD treatment was 2.14 [95% confidence interval (CI) 2.02-2.26] 
      in those on conventional synthetic (cs) DMARDs, 2.01 (95% CI 1.38-2.91) in those 
      on tumour necrosis factor (TNF) inhibitors as the only targeted agent, and 3.83 
      (95% CI 2.65-5.56) in those on other targeted DMARDs. Among those on csDMARDs, 
      rate ratios for hospitalized COVID-19 were lowest at 1.66 (95% CI 1.51-1.82) in 
      those on methotrexate and highest at 5.4 (95% CI 4.4-6.7) in those on 
      glucocorticoids at an average dose > 10 mg/day prednisolone equivalent. 
      CONCLUSION: The risk of hospitalized COVID-19 is elevated in IRD patients treated 
      with immunosuppressive drugs compared with the general population. Of these 
      drugs, methotrexate, hydroxychloroquine, and TNF inhibitors carry the lowest 
      risk. The highest risk is associated with prednisolone. A larger study is needed 
      to estimate reliably the risks associated with each class of targeted DMARD.
FAU - McKeigue, P M
AU  - McKeigue PM
AUID- ORCID: 0000-0002-5217-1034
AD  - Usher Institute, College of Medicine and Veterinary Medicine, University of 
      Edinburgh, Edinburgh, UK.
AD  - Public Health Scotland, Glasgow, UK.
FAU - Porter, D
AU  - Porter D
AUID- ORCID: 0000-0001-8481-5204
AD  - Department of Rheumatology, Gartnavel General Hospital, Glasgow, UK.
FAU - Hollick, R J
AU  - Hollick RJ
AUID- ORCID: 0000-0001-6558-7189
AD  - Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), 
      School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, 
      Aberdeen, UK.
FAU - Ralston, S H
AU  - Ralston SH
AUID- ORCID: 0000-0002-2804-7586
AD  - Institute of Genetics and Cancer, College of Medicine and Veterinary Medicine, 
      University of Edinburgh, Western General Hospital Campus, Edinburgh, UK.
FAU - McAllister, D A
AU  - McAllister DA
AUID- ORCID: 0000-0003-3550-1764
AD  - Public Health Scotland, Glasgow, UK.
AD  - Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
FAU - Colhoun, H M
AU  - Colhoun HM
AUID- ORCID: 0000-0002-8345-3288
AD  - Public Health Scotland, Glasgow, UK.
AD  - Institute of Genetics and Cancer, College of Medicine and Veterinary Medicine, 
      University of Edinburgh, Western General Hospital Campus, Edinburgh, UK.
LA  - eng
PT  - Journal Article
DEP - 20220512
PL  - England
TA  - Scand J Rheumatol
JT  - Scandinavian journal of rheumatology
JID - 0321213
RN  - YL5FZ2Y5U1 (Methotrexate)
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Immunosuppressive Agents)
RN  - 9PHQ9Y1OLM (Prednisolone)
SB  - IM
MH  - Humans
MH  - Methotrexate/therapeutic use
MH  - *Arthritis, Rheumatoid/drug therapy
MH  - Case-Control Studies
MH  - *COVID-19
MH  - *Antirheumatic Agents/therapeutic use
MH  - Immunosuppressive Agents/therapeutic use
MH  - Immunosuppression Therapy
MH  - Prednisolone/therapeutic use
MH  - *Rheumatic Diseases/drug therapy
EDAT- 2022/05/14 06:00
MHDA- 2023/06/14 06:42
CRDT- 2022/05/13 12:08
PHST- 2023/06/14 06:42 [medline]
PHST- 2022/05/14 06:00 [pubmed]
PHST- 2022/05/13 12:08 [entrez]
AID - 10.1080/03009742.2022.2063376 [doi]
PST - ppublish
SO  - Scand J Rheumatol. 2023 Jul;52(4):412-417. doi: 10.1080/03009742.2022.2063376. 
      Epub 2022 May 12.