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. 2023 Jan 14:6:100190.
doi: 10.1016/j.jtauto.2023.100190. eCollection 2023.

COVID-19 presentation and outcomes in patients with inflammatory rheumatic and musculoskeletal diseases receiving IL6-receptor antagonists prior to SARS-CoV-2 infection

Cloé Comarmond  1 , Elodie Drumez  2 , Julien Labreuche  2 , Eric Hachulla  3 , Thierry Thomas  4 , René-Marc Flipo  5 , Raphaëlle Seror  6 , Jérôme Avouac  7 , Nathalie Balandraud  8 , Renaud Desbarbieux  9 , Renaud Felten  10 , Mélanie Gilson  11 , Marie-Hélène Guyot  12 , Ambre Hittinger-Roux  13 , Thao Pham  8 , Myriam Renard  14 , Nicolas Roux  15 , Vincent Sobanski  3 , Anne Tournadre  16 , Christophe Richez  17 , Patrice Cacoub  18 ; FAI2 R/SFR/SNFMI/SOFREMIP/CRI/IMIDIATE consortium and contributors
Affiliations

COVID-19 presentation and outcomes in patients with inflammatory rheumatic and musculoskeletal diseases receiving IL6-receptor antagonists prior to SARS-CoV-2 infection

Cloé Comarmond et al. J Transl Autoimmun. .

Abstract

Objective: COVID-19 outcome may be less favourable in patients with inflammatory rheumatic and musculoskeletal diseases (RMD) receiving immunosuppressive therapy. We aimed to investigate whether RMD patients on anti-IL6 therapy prior to SARS-CoV-2 infection have less severe disease and better outcomes of COVID-19.

Methods: We conducted a retrospective national, multicentre cohort study using data from the French RMD COVID-19 cohort. We compared the severity and outcome of highly suspected or confirmed COVID-19 infection in RMD patients previously treated with tocilizumab or sarilumab (anti-IL6 group) with patients who did not receive anti-IL6 therapy (no anti-IL6 group).

Results: Data were collected for 1883 patients with mean age of 55.2 years [SD 16.7] and 1256 (66.7%) female. Two hundred ten (11.1%) developed severe COVID-19 and 115 (6.4%) died. After adjusting for potential confounding factors, severe COVID-19 was less frequent in the anti-IL6 group compared with the no anti-IL6 group (aOR for moderate vs. mild severity, 0.23 [95% CI, 0.10 to 0.54], p ≤ 0.01 and aOR for severe vs. mild, 0.29 [95% CI, 0.10 to 0.81], p ≤ 0.01). No significant differences were found for the evolution of COVID-19 between the anti-IL6 group and the no anti-IL6 group (aOR for recovery with sequelae vs recovery without sequelae, 0.78 [95% CI, 0.41 to 1.48] and aOR for death vs recovery without sequelae, 0.29 [95% CI, 0.07 to 1.30]).

Conclusion: RMD patients receiving anti-IL6 therapy prior to SARS-CoV-2 infection have less severe forms of COVID-19. No difference was observed in COVID-19 evolution, i.e., sequelae or death, between the groups.

Keywords: Anti-IL6; COVID-19; Inflammatory rheumatic and musculoskeletal diseases.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Effect sizes on COVID-19 severity according to anti-IL6 therapy received prior to SARS-CoV-2 infection and each control group.
See this image and copyright information in PMC

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