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Baseline medication use is associated with COVID-19 severity in people with rheumatic diseases

Baseline medication use is associated with COVID-19 severity in people with rheumatic diseases
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Rituximab a Hazard in RA Patients With COVID

email article Patients with rheumatoid arthritis (RA) treated with rituximab (Rituxan) or JAK inhibitors had more severe COVID-19 disease courses, analysis of data from a large registry found. In an adjusted multivariate analysis compared with patients on tumor necrosis factor (TNF) inhibitors, those on rituximab had a fourfold higher risk for worse disease (OR 4.15, 95% CI 3.16-5.44), while those on JAK inhibitors had a twofold greater risk (OR 2.06, 95% CI 1.60-2.65), reported Jeffrey Sparks, MD, of Harvard Medical School in Boston, at the European League Against Rheumatism virtual congress. As we all know, there has been intense interest during the pandemic in repurposing immune modulating drugs for COVID-19 treatment, he said.

Immunosuppressants and COVID-19

Immunosuppressants and COVID-19 Immunosuppressant drugs are currently being trialled as a potential COVID-19 treatment. Credit: Shidlovski / iStock / Getty Images Plus Immunosuppressant drugs commonly used for autoimmune diseases such as rheumatoid arthritis, psoriasis, and Crohn’s disease, might, in principle, increase the risk of severe COVID-19 infection and lower vaccines’ efficacy. Common cold and other upper respiratory tract infections, for example, can be more common in people taking immunosuppressants. Yet, some such drugs – glucocorticoids, anti-tumour necrosis factors (anti-TNF) and disease-modifying antirheumatic drugs (DMARDs) – are being trialled as potential COVID-19 therapeutics. Why does this conflicting dichotomy exist? The answer may lie in the difference between the chronic and acute use of these drugs.

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