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0 0.5 1 1.5 2+ Hospitalization -2% Improvement Relative Risk Case -3% Case, before adjustments 23% HCQ for COVID-19  Guillaume et al.  Prophylaxis Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? Retrospective 459 patients in France (April - April 2020) Study underpowered to detect differences Guillaume et al., Rheumatology and The.., Sep 2021 Favors HCQ Favors control

Antirheumatic Drug Intake Influence on Occurrence of COVID-19 Infection in Ambulatory Patients with Immune-Mediated Inflammatory Diseases: A Cohort Study

Guillaume et al., Rheumatology and Therapy, doi:10.1007/s40744-021-00373-1, NCT04345159
Sep 2021  
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HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
*, now known with p < 0.00000000001 from 421 studies, recognized in 42 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments.
Retrospective 459 SLE, RA, SjS, or PsA patients in France, showing no significant difference with HCQ treatment. However, the statistical analysis shows significant mismatches with prior research, which may be due to overfitting with the limited data and very small number of events. For example, the analysis estimates lower risk OR 0.72 for age, and shows very different relative risks of SLE, RA, SjS, or PsA compared to other research. We note the very different distribution of diseases in the groups, for example there is a much higher prevalence of PsA in the no HCQ group. The inaccurate estimations of risk for the different diseases and for age likely makes the adjusted analysis very inaccurate.
This study is excluded in the after exclusion results of meta analysis: statistical analysis shows significant mismatch with prior research, potential overfitting.
risk of hospitalization, 2.4% higher, RR 1.02, p = 1.00, treatment 2 of 181 (1.1%), control 3 of 278 (1.1%).
risk of case, 2.9% higher, RR 1.03, p = 0.96, treatment 6 of 181 (3.3%), control 12 of 278 (4.3%), adjusted per study, odds ratio converted to relative risk.
risk of case, 23.2% lower, RR 0.77, p = 0.63, treatment 6 of 181 (3.3%), control 12 of 278 (4.3%), NNT 100.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Guillaume et al., 16 Sep 2021, retrospective, France, peer-reviewed, survey, 25 authors, study period 17 April, 2020 - 30 April, 2020, trial NCT04345159 (history). Contact:
This PaperHCQAll
Antirheumatic Drug Intake Influence on Occurrence of COVID-19 Infection in Ambulatory Patients with Immune-Mediated Inflammatory Diseases: A Cohort Study
Debellemanière Guillaume, Bouvet Magalie, Elahi Sina, Salah-Mabed Imène, Vayr Frédéric, Dubois Mathieu, Muselier Aurore, Gozlan Yoni, Elbaz Emma, Badatcheff Charlotte, Fabre Laura, Saad Alain, Nahaisi Steven, Zeboulon Pierre, Febbraro Jean-Luc, Courtin Romain, Grise-Dulac Alice, Mazharian Adrien, Ghazal Wassim, Remongin Pierre-Emmanuel, Panthier Christophe, Chirouze Catherine, Bertrand Kevin, Sené Thomas, Gatinel Damien
Rheumatology and Therapy, doi:10.1007/s40744-021-00373-1
Introduction: We aimed to study the prevalence of a history of COVID-19 infection among patients suffering from systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), Sjo ¨gren's syndrome (SjS) or psoriatic arthritis (PsA), and the potential influence of long-term hydroxychloroquine (HCQ) intake. Methods: We performed an observational monocentric cohort study at the Adolphe de Rothschild Foundation Hospital ophthalmology division (Paris, France). Electronic medical records (EMR) data were searched for keywords associated with SLE, RA, SjS, or PsA. Patients were contacted by phone and were interviewed using a standardized questionnaire. The primary outcome was the occurrence of a positive COVID-19 test result during the study period. We determined the adjusted association between various antirheumatic drugs intake, COVID-19 risk factors, and occurrence of COVID-19 using a logistic regression model. This study is registered on (Identifier: NCT04345159). Results: Patients were recruited between Apr 17, 2020, and Apr 30, 2020 and were recontacted between Oct 6, 2020, and Nov 2, 2020. A total of 569 patients were included, of whom 459 patients were eligible for data analysis. One hundred and eighty-one patients were treated with long-term HCQ and 18 patients had tested positive for COVID-19. No antirheumatic drug intake, including HCQ intake, was significantly associated with an increased or decreased risk of developing COVID-19 infection. Conclusions: No antirheumatic drug intake was associated with an increased or decreased risk of developing COVID-19 infection in our cohort of patients suffering from immune-mediated inflammatory diseases.
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