Risk of severe COVID-19 in patients treated with IBD medications: a French nationwide study #MMPMID34110040
Meyer A; Semenzato L; Zureik M; Weill A; Carbonnel F; Dray-Spira R
Aliment Pharmacol Ther 2021[Jul]; 54 (2): 160-166 PMID34110040show ga
BACKGROUND: Recently, the SECURE-IBD study, based on a physician-reported registry, suggested that thiopurines, either alone or combined with anti-TNF, may increase risk of severe COVID-19. AIMS: To compare the risk of severe COVID-19 according to IBD medications in a large and unselected population. METHODS: Using the French national health data system, the risks of hospitalisation and of death or mechanical ventilation for COVID-19 from 15 February 2020 to 31 August 2020 in IBD patients were compared according to IBD treatment (immunomodulators and biologics), using multivariable Cox models adjusted for socio-demographic characteristics, budesonide/corticosteroids and aminosalicylates use, and comorbidities. RESULTS: Among 268 185 IBD patients, 600 were hospitalised for COVID-19 and 111 of them died or were mechanically ventilated (including 78 deaths). In multivariable analysis, the risk of hospitalisation for COVID-19 did not differ according to IBD treatment category, with adjusted Hazard Ratios (aHR, unexposed patients used as reference) of 0.94 (95%CI: 0.66-1.35) for immunomodulator monotherapy, 1.05 (0.80-1.38) for anti-TNF monotherapy, 0.80 (0.38-1.69) for anti-TNF combination therapy, 1.06 (0.55-2.05) for vedolizumab and 1.25 (0.64-2.43) for ustekinumab. Similarly, the risk of death or mechanical ventilation for COVID-19 did not differ according to IBD treatment. CONCLUSIONS: Immunomodulators and biologics prescribed in patients with IBD do not appear to increase the severity of COVID-19 infection.
Aliment+Pharmacol+Ther 2021 ; 54 (2): 160-166
