Scientific article
Open access

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

Published inRMD open, vol. 7, no. 3, e001711
Publication date2021-12
First online date2021-12-03

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
Citation (ISO format)
TALENG MELONG PIANTA, Cathy Mireille et al. Incidence of COVID-19 in patients treated with infliximab compared with patients treated with rituximab. In: RMD open, 2021, vol. 7, n° 3, p. e001711. doi: 10.1136/rmdopen-2021-001711
Main files (1)
Article (Published version)
Secondary files (1)
ISSN of the journal2056-5933

Technical informations

Creation12/08/2021 4:17:00 PM
First validation12/08/2021 4:17:00 PM
Update time03/16/2023 2:28:14 AM
Status update03/16/2023 2:28:13 AM
Last indexation05/06/2024 8:56:05 AM
All rights reserved by Archive ouverte UNIGE and the University of GenevaunigeBlack