Effect of IBD medications on COVID-19 outcomes: results from an international registry
Effect of IBD medications on COVID-19 outcomes: results from an international registry
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DOI：
10.1136/gutjnl-2020-322539
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发表时间：
2021-04-01
期刊：
影响因子：
24.5
通讯作者：
Kappelman, Michael D.
中科院分区：
文献类型：
--
作者：
Ungaro, Ryan C.;Brenner, Erica J.;Kappelman, Michael D.
目的我们试图评估接受不同药物类别和组合治疗的IBD患者的COVID-19临床病程。设计监测炎症性肠道疾病研究排除的冠状病毒流行病学（SECURE-IBD）是一个大型国际登记研究，旨在监测确诊为COVID-19的IBD患者的结局。我们使用多变量回归和广义估计方程，将国家作为随机效应，分析不同药物类别与严重COVID-19（定义为重症监护病房入院、呼吸机使用和/或死亡）的相关性。（平均年龄44.1岁，51.4%为男性），其中112名患者（7.8%）患有重度COVID-19。与肿瘤坏死因子（TNF）拮抗剂单药治疗相比，硫嘌呤单药治疗（校正OR（aOR）4.08，95% CI 1.73 - 9.61）和TNF拮抗剂与硫嘌呤联合治疗（aOR 4.01，95% CI 1.65 - 9.78）与重度COVID-19风险增加相关。与未使用美沙拉秦/柳氮磺胺吡啶相比，使用任何美沙拉秦/柳氮磺胺吡啶均与风险增加相关（aOR 1.70，95% CI 1.26 - 2.29）。当使用TNF拮抗剂单药治疗作为参考组时，该风险估计值增加（aOR 3.52，95% CI 1.93至6.45）。IL-12/23和整合素拮抗剂与TNF拮抗剂单药治疗的风险无显著差异（aOR分别为0.98，95%CI 0.12 - 8.06和aOR 2.42，95%CI 0.59 - 9.96）。结论联合治疗和硫嘌呤可能与严重COVID-19的风险增加有关。在比较生物制品类别时，未观察到显著差异。这些发现需要在大型人群队列中得到证实。对于共同最后作者行，MKH应更改为MDK
Objective We sought to evaluate COVID-19 clinical course in patients with IBD treated with different medication classes and combinations.Design Surveillance Epidemiology of Coronavirus Under Research Exclusion for Inflammatory Bowel Disease (SECURE-IBD) is a large, international registry created to monitor outcomes of IBD patients with confirmed COVID-19. We used multivariable regression with a generalised estimating equation accounting for country as a random effect to analyse the association of different medication classes with severe COVID-19, defined as intensive care unit admission, ventilator use and/or death.Results 1439 cases from 47 countries were included (mean age 44.1 years, 51.4% men) of whom 112 patients (7.8%) had severe COVID-19. Compared with tumour necrosis factor (TNF) antagonist monotherapy, thiopurine monotherapy (adjusted OR (aOR) 4.08, 95% CI 1.73 to 9.61) and combination therapy with TNF antagonist and thiopurine (aOR 4.01, 95% CI 1.65 to 9.78) were associated with an increased risk of severe COVID-19. Any mesalamine/sulfasalazine compared with no mesalamine/sulfasalazine use was associated with an increased risk (aOR 1.70, 95% CI 1.26 to 2.29). This risk estimate increased when using TNF antagonist monotherapy as a reference group (aOR 3.52, 95% CI 1.93 to 6.45). Interleukin-12/23 and integrin antagonists were not associated with significantly different risk than TNF antagonist monotherapy (aOR 0.98, 95% CI 0.12 to 8.06 and aOR 2.42, 95% CI 0.59 to 9.96, respectively).Conclusion Combination therapy and thiopurines may be associated with an increased risk of severe COVID-19. No significant differences were observed when comparing classes of biologicals. These findings warrant confirmation in large population-based cohorts. MKH should be changed to MDK for co-last author line