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Risk of severe COVID‐19 in patients treated with IBD medications: a French nationwide study
Author(s) -
Meyer Antoine,
Semenzato Laura,
Zureik Mahmoud,
Weill Alain,
Carbonnel Franck,
DraySpira Rosemary
Publication year - 2021
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.16410
Subject(s) - medicine , ustekinumab , mechanical ventilation , hazard ratio , population , inflammatory bowel disease , vedolizumab , covid-19 , proportional hazards model , budesonide , infliximab , disease , corticosteroid , confidence interval , environmental health , infectious disease (medical specialty)
Summary Background Recently, the SECURE‐IBD study, based on a physician‐reported registry, suggested that thiopurines, either alone or combined with anti‐TNF, may increase risk of severe COVID‐19. Aims To compare the risk of severe COVID‐19 according to IBD medications in a large and unselected population. Methods Using the French national health data system, the risks of hospitalisation and of death or mechanical ventilation for COVID‐19 from 15 February 2020 to 31 August 2020 in IBD patients were compared according to IBD treatment (immunomodulators and biologics), using multivariable Cox models adjusted for socio‐demographic characteristics, budesonide/corticosteroids and aminosalicylates use, and comorbidities. Results Among 268 185 IBD patients, 600 were hospitalised for COVID‐19 and 111 of them died or were mechanically ventilated (including 78 deaths). In multivariable analysis, the risk of hospitalisation for COVID‐19 did not differ according to IBD treatment category, with adjusted Hazard Ratios (aHR, unexposed patients used as reference) of 0.94 (95%CI: 0.66‐1.35) for immunomodulator monotherapy, 1.05 (0.80‐1.38) for anti‐TNF monotherapy, 0.80 (0.38‐1.69) for anti‐TNF combination therapy, 1.06 (0.55‐2.05) for vedolizumab and 1.25 (0.64‐2.43) for ustekinumab. Similarly, the risk of death or mechanical ventilation for COVID‐19 did not differ according to IBD treatment. Conclusions Immunomodulators and biologics prescribed in patients with IBD do not appear to increase the severity of COVID‐19 infection.