Article
Outcome of SARS-CoV-2 infection in patients with rheumatoid arthritis under treatment with Janus kinase inhibitors compared to etanercept
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Published: | September 14, 2021 |
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Introduction: Various immunosuppressants have been used as anti-inflammatory drugs and cytokine inhibitors to treat the complications of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) disease 2019 (COVID-19). Of these, there has been particular interest in the Janus kinase (JAK) inhibitors (I) with at least one controlled trial showing improvement of the course of disease. Therefore, we analysed in the German COVID-19 registry patients with COVID-19 and rheumatoid arthritis (RA) that were treated with JAK-I compared to RA patients treated with etanercept (ETC).
Methods: Data from the German physician-reported COVID-19 registry for inflammatory rheumatic diseases were analysed from March 30th, 2020 until April 5th, 2021 (in total 2253 cases). Of these, 128 patients were treated with JAK-I, and 94 patients with ETC. Using ETC as reference group, the group differences were tested by the Mann-Whitney U-Test, Pearson Chi-Square-Test and Fisher’s exact test.
Results: For both groups, median age was 58 years. Glucocorticoids were used in 50% of the JAK-I and in 33% of the ETC patients (p = 0.008). Conventional synthetic (cs) disease-modifying anti-rheumatic drugs (DMARD) were used in 29% of the JAK-I and 45% of the ETC patients (p = 0.015). Hospitalization was needed in 33% of the JAK-I and in 12% of the ETC patients (p < 0.001), and oxygen treatment in 25% and 6%, respectively (p < 0.001). Eight versus no (p = 0.011) fatal cases were reported in the JAK-i compared to the ETC group.
Conclusion: The study revealed that the hospitalisation rate during COVID-19 infection as well as the mortality was significantly higher in JAK-I as compared to ETC patients. Whether this is due to an increased risk for severe SARS-CoV-2 infection under JAK-I treatment of RA or to a decreased risk under TNF-I still needs clarification.
Disclosures: None declared
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