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Media type:
E-Article
Title:
Outcome of COVID-19 in patients with rheumatic and inflammatory diseases
treated with mycophenolic acid: data from the French RMD COVID-19
cohort
Description:
<jats:sec>
<jats:title>Background</jats:title>
<jats:p>Patients with inflammatory rheumatic and musculoskeletal diseases
(iRMD) receiving mycophenolic acid (MPA) may have a less favourable
outcome from COVID-19 infection. Our aim was to investigate whether MPA
treatment is associated with severe infection and/or death.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods</jats:title>
<jats:p>IRMD patients with and without MPA treatment with highly
suspected/confirmed COVID-19 were included in this observational
multicentre study. The primary outcome was death rate from COVID-19 with
secondary objectives to determine the severity of infection and length
of hospital stay. Outcome comparisons were made using regression models
with and without adjustment on prespecified confounding factors. ORs,
sub-HR (sHR) and 95% CIs were calculated using patients not treated with
MPA as a reference group.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results</jats:title>
<jats:p>Of the 1977 patients, 1928 were not treated with MPA (393 were MPA
eligible), and 49 patients were treated with MPA. MPA-treated patients
had more severe disease, longer hospital stays and higher death rate
from COVID-19 than non-MPA patients (OR 8.02 (95% CI 3.35 to 19.20),
p<0.001; sHR 0.57 (95% CI 0.33 to 0.98), p=0.040; OR 11.58 (95% CI
4.10 to 32.69), p<0.001). In adjusted analyses, however, no outcome
was independently associated with MPA treatment. Death rate, severity
and length of hospital stay of MPA-treated patients were not
significantly different from those of not treated but MPA-eligible
patients.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusion</jats:title>
<jats:p>MPA therapy is not associated with a more severe COVID-19 infection.
However, due to increased vulnerability of developing a severe form of
COVID-19, careful consideration should be taken with iRMD patients
likely to be treated with MPA.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Trial registration number</jats:title>
<jats:p><jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="nct" specific-use="clinicaltrial results" xlink:href="NCT04353609">NCT04353609</jats:ext-link>.</jats:p>
</jats:sec>