Effect of IBD medications on COVID-19 outcomes: results from an international registry
ObjectiveWe sought to evaluate COVID-19 clinical course in patients with IBD treated with different medication classes and combinations.DesignSurveillance Epidemiology of Coronavirus Under Research Exclusion for Inflammatory Bowel Disease (SECURE-IBD) is a large, international registry created to mo...
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| Veröffentlicht in: | Gut 2021-04, Vol.70 (4), p.725-732 |
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| creator | Ungaro, Ryan C Brenner, Erica J Gearry, Richard B Kaplan, Gilaad G Kissous-Hunt, Michele Lewis, James D Ng, Siew C Rahier, Jean-Francois Reinisch, Walter Steinwurz, Flávio Underwood, Fox E Zhang, Xian Colombel, Jean-Frederic Kappelman, Michael D |
| description | ObjectiveWe sought to evaluate COVID-19 clinical course in patients with IBD treated with different medication classes and combinations.DesignSurveillance 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.Results1439 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).ConclusionCombination 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 line |
| doi_str_mv | 10.1136/gutjnl-2020-322539 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8136807</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2497443704</sourcerecordid><originalsourceid>FETCH-LOGICAL-b573t-529e29c4f3e7c1d456d0346a436a67dc7dfaeccc4efeb8241fb4fe34197f3bd63</originalsourceid><addsrcrecordid>eNqNkc1u1DAUhS0EokPhBVggS2zYpPgvscMCqUxLGalSN6Vby3Guh4wSu9gOUt8eDykDZYG6sqz7naNz70HoNSUnlPLm_XbOOz9WjDBSccZq3j5BKyoaVX5KPUUrQqisainaI_QipR0hRKmWPkdHnBPFWFOv0M25c2AzDg5vPp3hCfrBmjwEn3DweH11szmraIvDnG2YIH3AEdI85oRdDBM2Hg8-Q_S_JGYs0-2Qcrx7iZ45MyZ4df8eo6-fz6_XX6rLq4vN-vSy6mrJc1WzFlhrheMgLe1F3fSEi8YI3phG9lb2zoC1VoCDTjFBXScccEFb6XjXN_wYfVx8b-euZLfgczSjvo3DZOKdDmbQDyd--Ka34YdW5YCKyGLw7t4ghu8zpKynIVkYR-MhzEkzUTIqSqUo6Nt_0F2Yy-rjnmqlEFySPcUWysaQUgR3CEOJ3teml9r0vja91FZEb_5e4yD53VMBqgXopt3jDE_-8IeY_xH8BIOjspQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2497443704</pqid></control><display><type>article</type><title>Effect of IBD medications on COVID-19 outcomes: results from an international registry</title><source>MEDLINE</source><source>PubMed Central</source><creator>Ungaro, Ryan C ; Brenner, Erica J ; Gearry, Richard B ; Kaplan, Gilaad G ; Kissous-Hunt, Michele ; Lewis, James D ; Ng, Siew C ; Rahier, Jean-Francois ; Reinisch, Walter ; Steinwurz, Flávio ; Underwood, Fox E ; Zhang, Xian ; Colombel, Jean-Frederic ; Kappelman, Michael D</creator><creatorcontrib>Ungaro, Ryan C ; Brenner, Erica J ; Gearry, Richard B ; Kaplan, Gilaad G ; Kissous-Hunt, Michele ; Lewis, James D ; Ng, Siew C ; Rahier, Jean-Francois ; Reinisch, Walter ; Steinwurz, Flávio ; Underwood, Fox E ; Zhang, Xian ; Colombel, Jean-Frederic ; Kappelman, Michael D</creatorcontrib><description>ObjectiveWe sought to evaluate COVID-19 clinical course in patients with IBD treated with different medication classes and combinations.DesignSurveillance 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.Results1439 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).ConclusionCombination 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 line</description><identifier>ISSN: 0017-5749</identifier><identifier>ISSN: 1468-3288</identifier><identifier>EISSN: 1468-3288</identifier><identifier>DOI: 10.1136/gutjnl-2020-322539</identifier><identifier>PMID: 33082265</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd and British Society of Gastroenterology</publisher><subject><![CDATA[Adult ; Anti-Inflammatory Agents - pharmacology ; Azathioprine - administration & dosage ; Azathioprine - adverse effects ; Cardiovascular disease ; Coronaviruses ; COVID-19 ; COVID-19 - diagnosis ; COVID-19 - epidemiology ; COVID-19 - immunology ; Drug Therapy, Combination - methods ; Drug Therapy, Combination - statistics & numerical data ; Epidemiology ; Fatalities ; Female ; Humans ; infectious disease ; Inflammatory bowel disease ; Inflammatory bowel diseases ; Inflammatory Bowel Diseases - drug therapy ; Inflammatory Bowel Diseases - virology ; Interleukin 12 ; International Cooperation ; Intestine ; Male ; Mercaptopurine - administration & dosage ; Mercaptopurine - adverse effects ; Registries - statistics & numerical data ; Risk Adjustment ; SARS-CoV-2 - drug effects ; SARS-CoV-2 - isolation & purification ; Severity of Illness Index ; Sulfasalazine ; Tumor necrosis factor ; Tumor Necrosis Factor Inhibitors - administration & dosage ; Tumor Necrosis Factor Inhibitors - adverse effects ; Tumor necrosis factor-TNF ; Tumors]]></subject><ispartof>Gut, 2021-04, Vol.70 (4), p.725-732</ispartof><rights>Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained. https://bmj.com/coronavirus/usage?</rights><rights>Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b573t-529e29c4f3e7c1d456d0346a436a67dc7dfaeccc4efeb8241fb4fe34197f3bd63</citedby><cites>FETCH-LOGICAL-b573t-529e29c4f3e7c1d456d0346a436a67dc7dfaeccc4efeb8241fb4fe34197f3bd63</cites><orcidid>0000-0001-8687-3758 ; 0000-0003-2719-0556 ; 0000-0002-2088-091X ; 0000-0002-6850-4454</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8136807/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8136807/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,882,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33082265$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ungaro, Ryan C</creatorcontrib><creatorcontrib>Brenner, Erica J</creatorcontrib><creatorcontrib>Gearry, Richard B</creatorcontrib><creatorcontrib>Kaplan, Gilaad G</creatorcontrib><creatorcontrib>Kissous-Hunt, Michele</creatorcontrib><creatorcontrib>Lewis, James D</creatorcontrib><creatorcontrib>Ng, Siew C</creatorcontrib><creatorcontrib>Rahier, Jean-Francois</creatorcontrib><creatorcontrib>Reinisch, Walter</creatorcontrib><creatorcontrib>Steinwurz, Flávio</creatorcontrib><creatorcontrib>Underwood, Fox E</creatorcontrib><creatorcontrib>Zhang, Xian</creatorcontrib><creatorcontrib>Colombel, Jean-Frederic</creatorcontrib><creatorcontrib>Kappelman, Michael D</creatorcontrib><title>Effect of IBD medications on COVID-19 outcomes: results from an international registry</title><title>Gut</title><addtitle>Gut</addtitle><addtitle>Gut</addtitle><description>ObjectiveWe sought to evaluate COVID-19 clinical course in patients with IBD treated with different medication classes and combinations.DesignSurveillance 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.Results1439 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).ConclusionCombination 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 line</description><subject>Adult</subject><subject>Anti-Inflammatory Agents - pharmacology</subject><subject>Azathioprine - administration & dosage</subject><subject>Azathioprine - adverse effects</subject><subject>Cardiovascular disease</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - diagnosis</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 - immunology</subject><subject>Drug Therapy, Combination - methods</subject><subject>Drug Therapy, Combination - statistics & numerical data</subject><subject>Epidemiology</subject><subject>Fatalities</subject><subject>Female</subject><subject>Humans</subject><subject>infectious disease</subject><subject>Inflammatory bowel disease</subject><subject>Inflammatory bowel diseases</subject><subject>Inflammatory Bowel Diseases - drug therapy</subject><subject>Inflammatory Bowel Diseases - virology</subject><subject>Interleukin 12</subject><subject>International Cooperation</subject><subject>Intestine</subject><subject>Male</subject><subject>Mercaptopurine - administration & dosage</subject><subject>Mercaptopurine - adverse effects</subject><subject>Registries - statistics & numerical data</subject><subject>Risk Adjustment</subject><subject>SARS-CoV-2 - drug effects</subject><subject>SARS-CoV-2 - isolation & purification</subject><subject>Severity of Illness Index</subject><subject>Sulfasalazine</subject><subject>Tumor necrosis factor</subject><subject>Tumor Necrosis Factor Inhibitors - administration & dosage</subject><subject>Tumor Necrosis Factor Inhibitors - adverse effects</subject><subject>Tumor necrosis factor-TNF</subject><subject>Tumors</subject><issn>0017-5749</issn><issn>1468-3288</issn><issn>1468-3288</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkc1u1DAUhS0EokPhBVggS2zYpPgvscMCqUxLGalSN6Vby3Guh4wSu9gOUt8eDykDZYG6sqz7naNz70HoNSUnlPLm_XbOOz9WjDBSccZq3j5BKyoaVX5KPUUrQqisainaI_QipR0hRKmWPkdHnBPFWFOv0M25c2AzDg5vPp3hCfrBmjwEn3DweH11szmraIvDnG2YIH3AEdI85oRdDBM2Hg8-Q_S_JGYs0-2Qcrx7iZ45MyZ4df8eo6-fz6_XX6rLq4vN-vSy6mrJc1WzFlhrheMgLe1F3fSEi8YI3phG9lb2zoC1VoCDTjFBXScccEFb6XjXN_wYfVx8b-euZLfgczSjvo3DZOKdDmbQDyd--Ka34YdW5YCKyGLw7t4ghu8zpKynIVkYR-MhzEkzUTIqSqUo6Nt_0F2Yy-rjnmqlEFySPcUWysaQUgR3CEOJ3teml9r0vja91FZEb_5e4yD53VMBqgXopt3jDE_-8IeY_xH8BIOjspQ</recordid><startdate>20210401</startdate><enddate>20210401</enddate><creator>Ungaro, Ryan C</creator><creator>Brenner, Erica J</creator><creator>Gearry, Richard B</creator><creator>Kaplan, Gilaad G</creator><creator>Kissous-Hunt, Michele</creator><creator>Lewis, James D</creator><creator>Ng, Siew C</creator><creator>Rahier, Jean-Francois</creator><creator>Reinisch, Walter</creator><creator>Steinwurz, Flávio</creator><creator>Underwood, Fox E</creator><creator>Zhang, Xian</creator><creator>Colombel, Jean-Frederic</creator><creator>Kappelman, Michael D</creator><general>BMJ Publishing Group Ltd and British Society of Gastroenterology</general><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-8687-3758</orcidid><orcidid>https://orcid.org/0000-0003-2719-0556</orcidid><orcidid>https://orcid.org/0000-0002-2088-091X</orcidid><orcidid>https://orcid.org/0000-0002-6850-4454</orcidid></search><sort><creationdate>20210401</creationdate><title>Effect of IBD medications on COVID-19 outcomes: results from an international registry</title><author>Ungaro, Ryan C ; Brenner, Erica J ; Gearry, Richard B ; Kaplan, Gilaad G ; Kissous-Hunt, Michele ; Lewis, James D ; Ng, Siew C ; Rahier, Jean-Francois ; Reinisch, Walter ; Steinwurz, Flávio ; Underwood, Fox E ; Zhang, Xian ; Colombel, Jean-Frederic ; Kappelman, Michael D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b573t-529e29c4f3e7c1d456d0346a436a67dc7dfaeccc4efeb8241fb4fe34197f3bd63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Anti-Inflammatory Agents - pharmacology</topic><topic>Azathioprine - administration & dosage</topic><topic>Azathioprine - adverse effects</topic><topic>Cardiovascular disease</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - diagnosis</topic><topic>COVID-19 - epidemiology</topic><topic>COVID-19 - immunology</topic><topic>Drug Therapy, Combination - methods</topic><topic>Drug Therapy, Combination - statistics & numerical data</topic><topic>Epidemiology</topic><topic>Fatalities</topic><topic>Female</topic><topic>Humans</topic><topic>infectious disease</topic><topic>Inflammatory bowel disease</topic><topic>Inflammatory bowel diseases</topic><topic>Inflammatory Bowel Diseases - drug therapy</topic><topic>Inflammatory Bowel Diseases - virology</topic><topic>Interleukin 12</topic><topic>International Cooperation</topic><topic>Intestine</topic><topic>Male</topic><topic>Mercaptopurine - administration & dosage</topic><topic>Mercaptopurine - adverse effects</topic><topic>Registries - statistics & numerical data</topic><topic>Risk Adjustment</topic><topic>SARS-CoV-2 - drug effects</topic><topic>SARS-CoV-2 - isolation & purification</topic><topic>Severity of Illness Index</topic><topic>Sulfasalazine</topic><topic>Tumor necrosis factor</topic><topic>Tumor Necrosis Factor Inhibitors - administration & dosage</topic><topic>Tumor Necrosis Factor Inhibitors - adverse effects</topic><topic>Tumor necrosis factor-TNF</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ungaro, Ryan C</creatorcontrib><creatorcontrib>Brenner, Erica J</creatorcontrib><creatorcontrib>Gearry, Richard B</creatorcontrib><creatorcontrib>Kaplan, Gilaad G</creatorcontrib><creatorcontrib>Kissous-Hunt, Michele</creatorcontrib><creatorcontrib>Lewis, James D</creatorcontrib><creatorcontrib>Ng, Siew C</creatorcontrib><creatorcontrib>Rahier, Jean-Francois</creatorcontrib><creatorcontrib>Reinisch, Walter</creatorcontrib><creatorcontrib>Steinwurz, Flávio</creatorcontrib><creatorcontrib>Underwood, Fox E</creatorcontrib><creatorcontrib>Zhang, Xian</creatorcontrib><creatorcontrib>Colombel, Jean-Frederic</creatorcontrib><creatorcontrib>Kappelman, Michael D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Gut</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ungaro, Ryan C</au><au>Brenner, Erica J</au><au>Gearry, Richard B</au><au>Kaplan, Gilaad G</au><au>Kissous-Hunt, Michele</au><au>Lewis, James D</au><au>Ng, Siew C</au><au>Rahier, Jean-Francois</au><au>Reinisch, Walter</au><au>Steinwurz, Flávio</au><au>Underwood, Fox E</au><au>Zhang, Xian</au><au>Colombel, Jean-Frederic</au><au>Kappelman, Michael D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of IBD medications on COVID-19 outcomes: results from an international registry</atitle><jtitle>Gut</jtitle><stitle>Gut</stitle><addtitle>Gut</addtitle><date>2021-04-01</date><risdate>2021</risdate><volume>70</volume><issue>4</issue><spage>725</spage><epage>732</epage><pages>725-732</pages><issn>0017-5749</issn><issn>1468-3288</issn><eissn>1468-3288</eissn><abstract>ObjectiveWe sought to evaluate COVID-19 clinical course in patients with IBD treated with different medication classes and combinations.DesignSurveillance 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.Results1439 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).ConclusionCombination 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 line</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd and British Society of Gastroenterology</pub><pmid>33082265</pmid><doi>10.1136/gutjnl-2020-322539</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-8687-3758</orcidid><orcidid>https://orcid.org/0000-0003-2719-0556</orcidid><orcidid>https://orcid.org/0000-0002-2088-091X</orcidid><orcidid>https://orcid.org/0000-0002-6850-4454</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0017-5749 |
| ispartof | Gut, 2021-04, Vol.70 (4), p.725-732 |
| issn | 0017-5749 1468-3288 1468-3288 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8136807 |
| source | MEDLINE; PubMed Central |
| subjects | Adult Anti-Inflammatory Agents - pharmacology Azathioprine - administration & dosage Azathioprine - adverse effects Cardiovascular disease Coronaviruses COVID-19 COVID-19 - diagnosis COVID-19 - epidemiology COVID-19 - immunology Drug Therapy, Combination - methods Drug Therapy, Combination - statistics & numerical data Epidemiology Fatalities Female Humans infectious disease Inflammatory bowel disease Inflammatory bowel diseases Inflammatory Bowel Diseases - drug therapy Inflammatory Bowel Diseases - virology Interleukin 12 International Cooperation Intestine Male Mercaptopurine - administration & dosage Mercaptopurine - adverse effects Registries - statistics & numerical data Risk Adjustment SARS-CoV-2 - drug effects SARS-CoV-2 - isolation & purification Severity of Illness Index Sulfasalazine Tumor necrosis factor Tumor Necrosis Factor Inhibitors - administration & dosage Tumor Necrosis Factor Inhibitors - adverse effects Tumor necrosis factor-TNF Tumors |
| title | Effect of IBD medications on COVID-19 outcomes: results from an international registry |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-18T09%3A06%3A17IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effect%20of%20IBD%20medications%20on%20COVID-19%20outcomes:%20results%20from%20an%20international%20registry&rft.jtitle=Gut&rft.au=Ungaro,%20Ryan%20C&rft.date=2021-04-01&rft.volume=70&rft.issue=4&rft.spage=725&rft.epage=732&rft.pages=725-732&rft.issn=0017-5749&rft.eissn=1468-3288&rft_id=info:doi/10.1136/gutjnl-2020-322539&rft_dat=%3Cproquest_pubme%3E2497443704%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2497443704&rft_id=info:pmid/33082265&rfr_iscdi=true |