tetano
Editor, Senior Moderator
Dermatol Ther
. 2021 May 25;e15003.
doi: 10.1111/dth.15003. Online ahead of print.
Tumor necrosis factor inhibitors are associated with a decreased risk of COVID-19-associated hospitalization in patients with psoriasis- A population-based cohort study
Khalaf Kridin[SUP] 1 2 [/SUP], Yochai Schonmann[SUP] 3 [/SUP], Giovanni Damiani[SUP] 4 5 [/SUP], Avi Peretz[SUP] 2 6 [/SUP], Erez Onn[SUP] 2 6 [/SUP], Dana Tzur Bitan[SUP] 7 [/SUP], Arnon D Cohen[SUP] 3 8 [/SUP]
Affiliations
Abstract
The risk of coronavirus disease 2019 (COVID-19) and its complications among patients with psoriasis treated by tumor necrosis factor inhibitors (TNFis) remains to be decisively delineated. We aimed to assess the risk of COVID-19 infection, COVID-19-associated hospitalization, and mortality among Israeli patients with psoriasis treated by TNFi relative to other systemic agents. A population-based cohort study was conducted to compare psoriasis patients treated by TNFi (n=1,943), with those treated by methotrexate (n=1,929), ustekinumab (n=348), and acitretin (n=1,892) regarding COVID-19 outcomes. Risk of investigated outcomes was assessed using uni- and multi-variate Cox regression analyses. The incidence rate of COVID-19, COVID-19-associated hospitalization, and mortality in the TNFi group was 35.8 (95% CI, 26.1-47.9), 0.8 (95% CI, 0.0-4.2), and 0.0 per 1,000 person-years, respectively. Exposure to TNFi was associated with a comparable risk of COVID-19 infection [adjusted hazard ration (HR) for TNFi vs. methotrexate: 1.07 (95% CI, 0.67-1.71); TNFi vs. ustekinumab: 1.07 (95% CI, 0.48-2.40); TNFi vs. acitretin: 0.98 (95% CI, 0.61-1.57)]. TNFi was associated with a decreased risk of COVID-19-associated hospitalization relative to methotrexate (adjusted HR, 0.10; 95% CI, 0.01-0.82) and ustekinumab (adjusted HR, 0.04; 95% CI, 0.00-0.64), but not to acitretin (adjusted HR, 1.00; 95% CI, 0.16-6.16). No significant difference in COVID-19-associated mortality was found between the four different groups. TNFi was associated with a decreased risk of admissions due to COVID-19. Our findings substantiate the continuation of TNFi treatment during the pandemic. TNFi may be positively considered in patients with moderate-to-severe psoriasis warranting systemic treatment during the pandemic. This article is protected by copyright. All rights reserved.
Keywords: Infection- bacterial/Fungal/Viral; Psoriasis.
. 2021 May 25;e15003.
doi: 10.1111/dth.15003. Online ahead of print.
Tumor necrosis factor inhibitors are associated with a decreased risk of COVID-19-associated hospitalization in patients with psoriasis- A population-based cohort study
Khalaf Kridin[SUP] 1 2 [/SUP], Yochai Schonmann[SUP] 3 [/SUP], Giovanni Damiani[SUP] 4 5 [/SUP], Avi Peretz[SUP] 2 6 [/SUP], Erez Onn[SUP] 2 6 [/SUP], Dana Tzur Bitan[SUP] 7 [/SUP], Arnon D Cohen[SUP] 3 8 [/SUP]
Affiliations
- PMID: 34033207
- DOI: 10.1111/dth.15003
Abstract
The risk of coronavirus disease 2019 (COVID-19) and its complications among patients with psoriasis treated by tumor necrosis factor inhibitors (TNFis) remains to be decisively delineated. We aimed to assess the risk of COVID-19 infection, COVID-19-associated hospitalization, and mortality among Israeli patients with psoriasis treated by TNFi relative to other systemic agents. A population-based cohort study was conducted to compare psoriasis patients treated by TNFi (n=1,943), with those treated by methotrexate (n=1,929), ustekinumab (n=348), and acitretin (n=1,892) regarding COVID-19 outcomes. Risk of investigated outcomes was assessed using uni- and multi-variate Cox regression analyses. The incidence rate of COVID-19, COVID-19-associated hospitalization, and mortality in the TNFi group was 35.8 (95% CI, 26.1-47.9), 0.8 (95% CI, 0.0-4.2), and 0.0 per 1,000 person-years, respectively. Exposure to TNFi was associated with a comparable risk of COVID-19 infection [adjusted hazard ration (HR) for TNFi vs. methotrexate: 1.07 (95% CI, 0.67-1.71); TNFi vs. ustekinumab: 1.07 (95% CI, 0.48-2.40); TNFi vs. acitretin: 0.98 (95% CI, 0.61-1.57)]. TNFi was associated with a decreased risk of COVID-19-associated hospitalization relative to methotrexate (adjusted HR, 0.10; 95% CI, 0.01-0.82) and ustekinumab (adjusted HR, 0.04; 95% CI, 0.00-0.64), but not to acitretin (adjusted HR, 1.00; 95% CI, 0.16-6.16). No significant difference in COVID-19-associated mortality was found between the four different groups. TNFi was associated with a decreased risk of admissions due to COVID-19. Our findings substantiate the continuation of TNFi treatment during the pandemic. TNFi may be positively considered in patients with moderate-to-severe psoriasis warranting systemic treatment during the pandemic. This article is protected by copyright. All rights reserved.
Keywords: Infection- bacterial/Fungal/Viral; Psoriasis.