Risk of COVID-19 hospitalization and mortality in rheumatic patients treated with hydroxychloroquine or other conventional DMARDs in Italy

{ 'indexed': {'date-parts': [[2023, 9, 1]], 'date-time': '2023-09-01T16:31:50Z', 'timestamp': 1693585910768}, 'reference-count': 37, 'publisher': 'Oxford University Press (OUP)', 'issue': 'SI', 'license': [ { 'start': { 'date-parts': [[2021, 4, 15]], 'date-time': '2021-04-15T00:00:00Z', 'timestamp': 1618444800000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model'}], 'funder': [{'name': 'Italian National Institute of Health'}], 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'published-print': {'date-parts': [[2021, 10, 9]]}, 'abstract': '<jats:title>Abstract</jats:title>\n' ' <jats:sec>\n' ' <jats:title>Objectives</jats:title>\n' ' <jats:p>To ascertain if the use of hydroxychloroquine(HCQ)/cloroquine(CLQ) ' 'and other conventional DMARDs (cDMARDs) and rheumatic diseases per se may be associated with ' 'COVID-19-related risk of hospitalization and mortality.</jats:p>\n' ' </jats:sec>\n' ' <jats:sec>\n' ' <jats:title>Methods</jats:title>\n' ' <jats:p>This case–control study nested within a cohort of cDMARD users was ' 'conducted in the Lombardy, Veneto, Tuscany and Lazio regions and Reggio Emilia province. ' 'Claims databases were linked to COVID-19 surveillance registries. The risk of ' 'COVID-19-related outcomes was estimated using a multivariate conditional logistic regression ' 'analysis comparing HCQ/CLQ vs MTX, vs other cDMARDs and vs non-use of these drugs. The ' 'presence of rheumatic diseases vs their absence in a non-nested population was ' 'investigated.</jats:p>\n' ' </jats:sec>\n' ' <jats:sec>\n' ' <jats:title>Results</jats:title>\n' ' <jats:p>A total of 1275 patients hospitalized due to COVID-19 were matched ' 'to 12 734 controls. Compared with recent use of MTX, no association between HCQ/CLQ ' 'monotherapy and COVID-19 hospitalization [odds ratio (OR) 0.83 (95% CI 0.69, 1.00)] or ' 'mortality [OR 1.19 (95% CI 0.85, 1.67)] was observed. A lower risk was found when comparing ' 'HCQ/CLQ use with the concomitant use of other cDMARDs and glucocorticoids. HCQ/CLQ was not ' 'associated with COVID-19 hospitalization as compared with non-use. An increased risk for ' 'recent use of either MTX monotherapy [OR 1.19 (95% CI 1.05, 1.34)] or other cDMARDs [OR 1.21 ' '(95% CI 1.08, 1.36)] vs non-use was found. Rheumatic diseases were not associated with ' 'COVID-19-related outcomes.</jats:p>\n' ' </jats:sec>\n' ' <jats:sec>\n' ' <jats:title>Conclusion</jats:title>\n' ' <jats:p>HCQ/CLQ use in rheumatic patients was not associated with a ' 'protective effect against COVID-19-related outcomes. The use of other cDMARDs was associated ' 'with an increased risk when compared with non-use and, if concomitantly used with ' 'glucocorticoids, also vs HCQ/CLQ, probably due to immunosuppressive action.</jats:p>\n' ' </jats:sec>', 'DOI': '10.1093/rheumatology/keab348', 'type': 'journal-article', 'created': {'date-parts': [[2021, 4, 13]], 'date-time': '2021-04-13T18:52:28Z', 'timestamp': 1618339948000}, 'page': 'SI25-SI36', 'source': 'Crossref', 'is-referenced-by-count': 11, 'title': 'Risk of coronavirus disease 2019 hospitalization and mortality in rheumatic patients treated ' 'with hydroxychloroquine or other conventional disease-modifying anti-rheumatic drugs in Italy', 'prefix': '10.1093', 'volume': '60', 'author': [ { 'given': 'Stefania', 'family': 'Spila Alegiani', 'sequence': 'first', 'affiliation': [ { 'name': 'Pharmacoepidemiology Unit, National Centre for Drug Research and ' 'Evaluation, Istituto Superiore di Sanità, Rome, Italy'}]}, { 'given': 'Salvatore', 'family': 'Crisafulli', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Biomedical and Dental Sciences and ' 'Morphofunctional Imaging, University of Messina, Messina, Italy'}, {'name': 'Italian Society of Pharmacology, Milan, Italy'}]}, { 'given': 'Paolo', 'family': 'Giorgi Rossi', 'sequence': 'additional', 'affiliation': [ { 'name': 'Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di ' 'Reggio Emilia, Reggio Emilia, Italy'}]}, { 'given': 'Pamela', 'family': 'Mancuso', 'sequence': 'additional', 'affiliation': [ { 'name': 'Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di ' 'Reggio Emilia, Reggio Emilia, Italy'}]}, { 'given': 'Carlo', 'family': 'Salvarani', 'sequence': 'additional', 'affiliation': [ { 'name': 'Unit of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, Reggio ' 'Emilia, Italy'}, { 'name': 'Department of Surgery, Medicine, Dentistry and Morphological ' 'Sciences with Interest in Transplant, Oncology and Regenerative ' 'Medicine, University of Modena and Reggio Emilia, Modena, ' 'Emilia-Romagna, Italy'}]}, { 'given': 'Fabiola', 'family': 'Atzeni', 'sequence': 'additional', 'affiliation': [ { 'name': 'Rheumatology Unit, Department of Experimental and Internal ' 'Medicine, University of Messina, Messina, Italy'}]}, { 'given': 'Rosa', 'family': 'Gini', 'sequence': 'additional', 'affiliation': [{'name': 'Agenzia Regionale di Sanità della Toscana, Florence, Italy'}]}, { 'given': 'Ursula', 'family': 'Kirchmayer', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Epidemiology ASL Roma 1, Lazio Regional Health ' 'Service, Rome, Italy'}]}, { 'given': 'Valeria', 'family': 'Belleudi', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Epidemiology ASL Roma 1, Lazio Regional Health ' 'Service, Rome, Italy'}]}, { 'given': 'Peter Konstantin', 'family': 'Kurotschka', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Medical Sciences and Public Health, Faculty of ' 'Medicine and Surgery, 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