RT Journal Article
SR Electronic
T1 Effect of IBD medications on COVID-19 outcomes: results from an international registry
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP 725
OP 732
DO 10.1136/gutjnl-2020-322539
VO 70
IS 4
A1 Ungaro, Ryan C
A1 Brenner, Erica J
A1 Gearry, Richard B
A1 Kaplan, Gilaad G
A1 Kissous-Hunt, Michele
A1 Lewis, James D
A1 Ng, Siew C
A1 Rahier, Jean-Francois
A1 Reinisch, Walter
A1 Steinwurz, Flávio
A1 Underwood, Fox E
A1 Zhang, Xian
A1 Colombel, Jean-Frederic
A1 Kappelman, Michael D
YR 2021
UL http://gut.bmj.com/content/70/4/725.abstract
AB 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 lineData are available on reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. All raw data are available at the SECURE-IBD website at covidibd.org.