Incidence of COVID-19 in patients treated with infliximab compared with patients treated with rituximab

Article Article scientifique Article Incidence of COVID-19 in patients treated with infliximab compared with patients treated with rituximab eng 2021-12-03 2021-12 author Taleng Melong Pianta Cathy Mireille 0000-0002-1352-8504 947774 Cathy Mireille Taleng Melong Pianta author Lauper Kim 0000-0002-4315-9009 552026 author Gilbert Benoît Thomas P. 0000-0001-6037-6470 801910 author Cunningham Timothy John 26835 author Guemara Romain 755111 author Brulhart Laure Sophie 93975 author Dan Diana author Courvoisier Delphine 0000-0002-1956-2607 94475 author Finckh Axel 0000-0002-1210-4347 22454 e001711 10.1136/rmdopen-2021-001711 34862310 2056-5933 PMC8646967 https://rmdopen.bmj.com/content/7/3/e001711 Objective: To determine whether patients with inflammatory autoimmune diseases treated with rituximab (RTX) have more severe forms of COVID-19 compared with patients treated with anticytokine therapies, such as Tumour Necrosis Factor (TNF) inhibitors. Methods: We included all patients who were on either RTX or infliximab (IFX) in two Swiss cantons during the first wave of the COVID-19 pandemic. We collected self-reported symptoms compatible with COVID-19, PCR-confirmed diagnoses of COVID-19 and the evolution of COVID-19 infections. We computed the raw and propensity score-adjusted incidence of COVID-19 by treatment group. Results: 190 patients were enrolled, of whom 121 (64%) were in the RTX group and 69 (36%) were in the IFX group. Twenty-one patients (11%) reported symptoms compatible with COVID-19 (RTX: 10, IFX: 11, p=0.14). Among patients with COVID-19 symptoms, four developed severe forms of the disease, with life-threatening pulmonary manifestations requiring intensive mechanical ventilation (RTX: 4 of 10, IFX: 0 of 11, Fisher's exact test p=0.04). The incidence rate of COVID-19 symptoms was 0.73 (95% CI 0.39 to 1.37) cases 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 rate of severe COVID-19 was 0.28 (95% CI 0.08 to 0.7.2) cases 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 independent validation cohort confirmed these findings, with consistent results in the Swiss Clinical Quality Management registry. Conclusion: While the incidence of symptoms compatible with COVID-19 was overall similar in patients receiving RTX or IFX, the incidence of severe COVID-19 tended to be higher in the RTX group. COVID-19 Epidemiology Infliximab Rituximab Dewey 616 56 Département de médecine 221 false 28 Inflammation articulaire 44 1291 Recherche clinique dans les rhumatismes inflammatoires 1010 RMD open 7 3 826f8fd5-d04c-4e7b-84a8-2aa37ac28bf1 Article (Published version) Public Article-scientifique-from-unpaywall.pdf 483838 application/pdf CC BY-NC-4.0 f11fc116-08c6-4c9a-8e7b-6b9935eb0987 Appendix Public rmdopen-2021-001711supp001.pdf 53060 application/pdf openAccess Faculté de médecine / Section de médecine clinique / Département de médecine

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Incidence of COVID-19 in patients treated with infliximab compared with patients treated with rituximab	RMD open			2021	267	129

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Cunningham, Timothy John