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

dc.rights.licenseopenen_US
dc.contributor.authorAVOUAC, J.
dc.contributor.authorDRUMEZ, E.
dc.contributor.authorHACHULLA, E.
dc.contributor.authorSEROR, R.
dc.contributor.authorGEORGIN-LAVIALLE, S.
dc.contributor.authorEL MAHOU, S.
dc.contributor.authorPERTUISET, E.
dc.contributor.authorPHAM, T.
dc.contributor.authorMAROTTE, H.
dc.contributor.authorSERVETTAZ, A.
dc.contributor.authorDOMONT, F.
dc.contributor.authorCHAZERAIN, P.
dc.contributor.authorDEVAUX, M.
dc.contributor.authorCLAUDEPIERRE, P.
dc.contributor.authorLANGLOIS, V.
dc.contributor.authorMEKINIAN, A.
dc.contributor.authorMARIA, A.T.J.
dc.contributor.authorBANNEVILLE, B.
dc.contributor.authorFAUTREL, B.
dc.contributor.authorPOUCHOT, J.
dc.contributor.authorTHOMAS, T.
dc.contributor.authorFLIPO, R.-M.
hal.structure.identifierImmunology from Concept and Experiments to Translation = Immunologie Conceptuelle, Expérimentale et Translationnelle [ImmunoConcept]
dc.contributor.authorRICHEZ, Christophe
dc.date.accessioned2022-05-03T12:53:33Z
dc.date.available2022-05-03T12:53:33Z
dc.date.issued2021-06
dc.identifier.issn2665-9913en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/139970
dc.description.abstractEnBackground : 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. Methods : 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 others]). Odds ratios and hazard ratios and their 95% CIs were calculated as effect size, by dividing the two population mean differences by their SD. This study is registered with ClinicalTrials.gov, NCT04353609. Findings : 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). Interpretation : 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.
dc.language.isoENen_US
dc.title.enCOVID-19 outcomes in patients with inflammatory rheumatic and musculoskeletal diseases treated with rituximab: a cohort study
dc.typeArticle de revueen_US
dc.identifier.doi10.1016/S2665-9913(21)00059-Xen_US
dc.subject.halSciences du Vivant [q-bio]/Immunologieen_US
dc.identifier.pubmed33786454en_US
bordeaux.journalThe Lancet Rheumatologyen_US
bordeaux.pagee419-e426en_US
bordeaux.volume3en_US
bordeaux.hal.laboratoriesImmunoConcEpT - UMR 5164en_US
bordeaux.issue6en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionCNRSen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.exportfalse
dc.rights.ccPas de Licence CCen_US
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