We computed the uncooked and propensity score-adjusted incidence of COVID-19 by treatment group

We computed the uncooked and propensity score-adjusted incidence of COVID-19 by treatment group. Results 190 individuals were enrolled, of whom 121 (64%) were in the RTX group and 69 (36%) were in the IFX group. the COVID-19 pandemic. We collected self-reported symptoms compatible with COVID-19, PCR-confirmed diagnoses of COVID-19 and the development of COVID-19 infections. We computed the uncooked and propensity score-adjusted incidence Rabbit Polyclonal to Caspase 3 (Cleaved-Ser29) of COVID-19 by treatment group. Results 190 patients were enrolled, of whom 121 (64%) were in the RTX group and 69 (36%) TH 237A were in the IFX group. Twenty-one individuals (11%) reported symptoms compatible with COVID-19 (RTX: 10, IFX: 11, p=0.14). Among individuals with COVID-19 symptoms, four developed severe forms of the disease, with life-threatening pulmonary manifestations requiring intensive mechanical air flow (RTX: 4 of 10, IFX: 0 of 11, Fishers precise test p=0.04). The incidence rate of COVID-19 symptoms was 0.73 (95% CI 0.39 to 1 1.37) instances per 1000 patient-days on RTX vs 1.52 (95% CI 0.82 to 2.85) cases per 1000 patient-days on IFX (crude p=0.10, adjusted p=0.07). The incidence TH 237A rate of severe COVID-19 was 0.28 (95% CI 0.08 to 0.7.2) TH 237A instances per 1000 patient-days on RTX compared with null on IFX (95% CI 0.0 to 0.44) (p=0.13). A replication in an self-employed validation cohort confirmed these findings, with consistent results in the Swiss Clinical Quality Management registry. Summary While the incidence of symptoms compatible with COVID-19 was overall related in individuals receiving RTX or IFX, the incidence of severe COVID-19 tended to become higher in the RTX group. strong class=”kwd-title” Keywords: rituximab, infliximab, COVID-19, epidemiology Important communications What is already known about this subject? While individuals with chronic inflammatory rheumatic and musculoskeletal diseases (RMDs) have an increased risk of developing severe forms of COVID-19, it is still unclear if this improved risk is related to the underlying disease or to immunosuppressive treatments. The risk of severe development of SARS-CoV-2 illness may vary depending on the mechanism of action of immunosuppressive treatments. What does this study add? The incidence of severe COVID-19 development appears to be improved in individuals treated with rituximab compared with individuals treated with TNF inhibitors. How might this impact on medical practice or further developments? These results suggest prudence should be observed when using immunosuppressive biotherapies, in particular rituximab, in individuals with RMDs during the SARS-CoV-2 pandemic. Intro Since the end of 2019, COVID-19 offers spread to all continents. In Switzerland, the prevalence of anti-SARS-CoV-2 IgG antibodies in the Geneva human population was estimated to be 9.7% at the end of April 2020 and over 20% in early 2021.1 2 Individuals with any immunosuppressive condition are at higher risk of developing severe forms of COVID-19 illness. In the UK, individuals with rheumatic and musculoskeletal diseases (RMDs) had an increased relative risk (RR=1.19) of dying from COVID-19 compared with the general population.3 However, it is currently still unclear whether this increased risk of death is due to the underlying inflammatory rheumatism, the associated comorbidities or to the treatments received by individuals with these conditions. Several studies suggest an increased risk of severe COVID-19 in individuals with RMDs associated with active disease on one hand and associated with specific immunosuppressive antirheumatic providers, such as Janus kinase inhibitor and RTX, on the other hand.4 5 Some mechanisms linking increased risk of severe COVID-19 with rituximab (RTX) have been proposed. For instance, by causing, RTX prospects to long-lasting immunosuppression due to B lymphocyte depletion, which may explain the improved risk of viral infections. Interestingly, RTX has also been associated with an improved risk of JC polyomavirus illness, responsible for an often lethal multifocal leucoencephalopathy.6 We hypothesised that long-lasting, cell-depleting therapies may increase the risk of developing a severe COVID-19 infection compared with targeted anticytokinic therapies, such as TNF inhibitors. The aim of this study was to determine whether individuals treated with B cell-depleting therapy RTX have.