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  • B-cell targeted therapy is associated with severe COVID-19 among patients with inflammatory arthritides: a 1-year multicentre study in 1116 successive patients receiving intravenous biologics

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B-cell targeted therapy is associated with severe COVID-19 among patients with inflammatory arthritides: a 1-year multicentre study in 1116 successive patients receiving intravenous biologics
  1. Renaud Felten1,2,
  2. Pierre-Marie Duret3,
  3. Elodie Bauer4,
  4. Nathanael Sedmak5,
  5. Julien H Djossou6,
  6. Massiva Bensalem1,
  7. Marc Ardizzone7,
  8. Marion Geoffroy8,
  9. Angelique Fan9,
  10. Marion Couderc9,
  11. Jean Hugues Salmon8,10,
  12. Laurent Messer3,
  13. Rose-Marie Javier1,
  14. Alain Meyer1,
  15. Emmanuel Chatelus1,
  16. Christelle Sordet1,
  17. Luc Pijnenburg1,
  18. Jérémy Fort1,
  19. Marina Rinagel1,
  20. Julia Walther11,
  21. Cassandre Fabre11,
  22. Laurent Arnaud1,
  23. Jean Sibilia1,
  24. Nicolas Meyer5,
  25. Francis Berenbaum6,12,
  26. isabelle Chary-Valckenaere4,
  27. Martin Soubrier9,
  28. Jérémie Sellam6,12,
  29. Jacques-Eric Gottenberg1,2
  1. 1 Service de Rhumatologie, Centre National de Référence des Maladies Auto-immunes Systémiques Rares Est Sud-Ouest (RESO), Hôpitaux universitaires de Strasbourg, Strasbourg, France
  2. 2 Laboratoire d’Immunopathologie et de Chimie Thérapeutique, Institut de Biologie Moléculaire et Cellulaire (IBMC), CNRS UPR3572, IBMC, Strasbourg, France
  3. 3 Service de Rhumatologie, Hôpital Pasteur, Colmar, France
  4. 4 Service de Rhumatologie, Hôpitaux Universitaires de Nancy, Nancy, France
  5. 5 Département de Santé Publique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
  6. 6 Service de Rhumatologie, Hôpital Saint-Antoine, Paris, France
  7. 7 Service de Rhumatologie, Hôpital de Mulhouse, Mulhouse, France
  8. 8 Service de Rhumatologie, Centre Hospitalier Universitaire de Reims, Reims, France
  9. 9 Service de Rhumatologie, Hôpitaux Universitaires de Clermont-Ferrand, Clermont-Ferrand, France
  10. 10 Faculté de Médicine, EA 3797, Reims, F-51095, Université de Reims Champagne-Ardenne, Reims, France
  11. 11 Service de Pharmacie-Stérilisation, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
  12. 12 Inserm UMRS_938, Sorbonne Université, F-75012 Paris, France, FHU PaCeMM (Paris Center for Microbiome Medicine), APHP, Paris, France
  1. Correspondence to Dr Jacques-Eric Gottenberg, Service de rhumatologie, Centre National de Référence des Maladies Auto-immunes Systémiques Rares Est Sud-Ouest (RESO), Hôpitaux Universitaires de Strasbourg, Strasbourg, France; jacques-eric.gottenberg{at}chru-strasbourg.fr

https://doi.org/10.1136/annrheumdis-2021-220549

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    Dear Editor,

    A potential association between rituximab and more severe COVID-19 outcomes has been previously raised, based on case reports, retrospective studies and mostly declarative registries.1–4 To further investigate this association, we focused on patients with inflammatory arthritides (IA) receiving intravenous biological agents at day hospitals to limit selection and recall bias, as well as missing data.

    All patients with IA treated in day hospitals with intravenous biological agents (rituximab, abatacept, infliximab or tocilizumab) in seven clinical centres in France (Strasbourg, Colmar, Mulhouse, Nancy, Reims, Clermont-Ferrand and Saint-Antoine hospitals in Paris) were enrolled in the study. Data were collected from 1 September 2019 (5 months before the outbreak of the epidemic in France, so that all enrolled patients had been exposed to a biologic prior to the start of the epidemic) to 1 January 2021.3 In each centre, we obtained the list of all patients receiving intravenous biological agents from the hospital pharmacist. Therefore, all patients receiving one of the four drugs within the time frame of the study were enrolled in each centre. The occurrence of hospitalised COVID-19 was the primary outcome criterion, that is, SARS-CoV-2 presence confirmed by PCR and resulting in hospitalisation or death. Data were analysed with Bayesian methods in univariate and multivariate analyses …

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    Footnotes

    • Handling editor Josef S Smolen

    • Twitter @larhumato

    • Contributors All authors contributed to the concept, design and drafting of the study and approved the final version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.