Machado P. Characteristics associated with poor COVID-19 outcomes in people with psoriasis and spondyloarthritis: data from physician-reported COVID-19 PsoProtect and Global Rheumatology Alliance registries. Presented at: EULAR Congress 2022; June 1-4, 2022 (virtual meeting).
Disclosures: Machado does not report any relevant financial information.
Data from US and European COVID-19 registries of patients with rheumatic diseases provided actionable insights to help rheumatologists manage patients with the virus, according to data presented at EULAR Congress 2022.
“Our patients, doctors and other healthcare professionals, they were all very worried because potentially they could be at risk of serious illness and serious consequences of SARS-CoV-2 infection“, Pedro Machado, MD, associate professor and consultant in rheumatology and neuromuscular diseases at University College London, University College Hospital, the National Hospital for Neurology and Neurosurgery and Northwick Park Hospital, said at a press conference.
There were three main reasons for this concern, according to Machado. One is the negative impact of rheumatological and autoimmune diseases on the ability of the immune system to fight infection. Another is the negative impact of immunomodulatory drugs on the immune system. Third is the fact that many immune-mediated inflammatory diseases affect multiple organ systems, ranging from the skin and joints to the heart and lungs. “For all of these reasons, our patients were very concerned,” Machado said.
Machado discussed the PsoProtect data and Global Rheumatology Alliance records reported by physicians.
“There was a need to quickly collect data for patients with rheumatic diseases who developed COVID,” he said.
The pooled analysis included results from over 5,000 patients. The results showed a hospitalization rate of 14.6% and a mortality rate of 1.8%.
Increasing age was a key factor in the more serious consequences of the virus. In addition, men were more likely than women to experience a serious infection.
“We were also able to show that many of the risk factors associated with a worse COVID-19 outcome in the general population are also risk factors in patients with rheumatic diseases,” Machado said.
Underlying comorbidities such as hypertension, lung disease, chronic kidney disease, and diabetes have all been driving more severe COVID-19 outcomes.
Additionally, patients with higher disease activity for their rheumatic or autoimmune condition were more likely to experience complications from COVID-19.
However, the news was not all bad. Several disease-modifying anti-rheumatic drugs – including interleukin (IL)-17 inhibitors, IL-23/IL-12+23 inhibitors, Janus kinase inhibitors and apremilast (Otezla , Amgen) – were found to be safe in COVID-19, in that they did not demonstrate associations with poorer outcomes.
“We were able to demonstrate that many drugs we use in rheumatology, including many biologics, are actually quite safe in the context of SARS-CoV-2 infection,” Machado said.
That said, glucocorticoids and B cell depletion therapies such as rituximab (Rituxan, Genentech) have demonstrated some complications as part of COVID-19, according to Machado.
“These data have really informed the management of patients with rheumatic diseases,” he said.
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