Title :

Covid-19 outcomes in patients with inflammatory rheumatic and musculoskeletal diseases treated with rituximab: a cohort study

Author(s) :

Avouac, Jerome [Auteur]
Drumez, Elodie [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Hachulla, Eric [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Seror, Raphaele [Auteur]

Georgin-Lavialle, Sophie [Auteur]
CHU Tenon [AP-HP]
El Mahou, Soumaya [Auteur]
Centre Hospitalier Tourcoing
Pertuiset, Edouard [Auteur]
Centre Hospitalier René Dubos [Pontoise]
Pham, Thao [Auteur]
Service de Rhumatologie [CHU Sainte Marguerite]
Marotte, Hubert [Auteur]
Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] [CHU ST-E]
Centre d'Investigation Clinique - Epidémiologie Clinique [CHU Saint-Etienne] [CIC-EC 1408]
Servettaz, Amelie [Auteur]
Hôpital Robert Debré
Domont, Fanny [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Chazerain, Pascal [Auteur]
Groupe Hospitalier Diaconesses Croix Saint-Simon
Devaux, Mathilde [Auteur]
CHI Poissy-Saint-Germain
Claudepierre, Pascal [Auteur]
Epidemiology in Dermatology and Evaluation in Therapeutics [EpiDermE]
Langlois, Vincent [Auteur]
Groupe Hospitalier du Havre Hôpital Jacques Monod (MONTIVILLIERS) [GHH]
Mekinian, Arsene [Auteur]
CHU Saint-Antoine [AP-HP]
Maria, Alexandre Thibault Jacques [Auteur]
CHU Montpellier = Montpellier University Hospital
Banneville, Beatrice [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Fautrel, Bruno [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Pouchot, Jacques [Auteur]
Hôpital Européen Georges Pompidou [APHP] [HEGP]
Thomas, Thierry [Auteur]
Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] [CHU ST-E]
Flipo, Rene-Marc [Auteur]
Service de rhumatologie[Lille]
Richez, Christophe [Auteur]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]

Journal title :

The Lancet Rheumatology

Abbreviated title :

Lancet Rheumatol

Publication date :

2021-03-25

ISSN :

2665-9913

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Various observations have suggested that the course of COVID-19 might be less favourable in patients with inflammatory rheumatic and musculoskeletal diseases receiving rituximab compared with those not receiving rituximab. ...
Show more >Various observations have suggested that the course of COVID-19 might be less favourable in patients with inflammatory rheumatic and musculoskeletal diseases receiving rituximab compared with those not receiving rituximab. We aimed to investigate whether treatment with rituximab is associated with severe COVID-19 outcomes in patients with inflammatory rheumatic and musculoskeletal diseases. In this cohort study, we analysed data from the French RMD COVID-19 cohort, which included patients aged 18 years or older with inflammatory rheumatic and musculoskeletal diseases and highly suspected or confirmed COVID-19. The primary endpoint was the severity of COVID-19 in patients treated with rituximab (rituximab group) compared with patients who did not receive rituximab (no rituximab group). Severe disease was defined as that requiring admission to an intensive care unit or leading to death. Secondary objectives were to analyse deaths and duration of hospital stay. The inverse probability of treatment weighting propensity score method was used to adjust for potential confounding factors (age, sex, arterial hypertension, diabetes, smoking status, body-mass index, interstitial lung disease, cardiovascular diseases, cancer, corticosteroid use, chronic renal failure, and the underlying disease [rheumatoid arthritis vs Between April 15, 2020, and Nov 20, 2020, data were collected for 1090 patients (mean age 55·2 years [SD 16·4]); 734 (67%) were female and 356 (33%) were male. Of the 1090 patients, 137 (13%) developed severe COVID-19 and 89 (8%) died. After adjusting for potential confounding factors, severe disease was observed more frequently (effect size 3·26, 95% CI 1·66-6·40, p=0·0006) and the duration of hospital stay was markedly longer (0·62, 0·46-0·85, p=0·0024) in the 63 patients in the rituximab group than in the 1027 patients in the no rituximab group. 13 (21%) of 63 patients in the rituximab group died compared with 76 (7%) of 1027 patients in the no rituximab group, but the adjusted risk of death was not significantly increased in the rituximab group (effect size 1·32, 95% CI 0·55-3·19, p=0·53). Rituximab therapy is associated with more severe COVID-19. Rituximab will have to be prescribed with particular caution in patients with inflammatory rheumatic and musculoskeletal diseases. None.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Inserm
Université de Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2021-07-06T12:44:33Z
2024-02-05T15:15:06Z