Risk-mitigating behaviours in people with inflammatory skin and joint disease during the COVID-19 pandemic differ by treatment type

Background: Registry data suggest that people with immune-mediated inflammatory diseases (IMIDs) receiving targeted systemic therapies have fewer adverse coronavirus disease 2019 (COVID-19) outcomes compared with patients receiving no systemic treatments. Objectives: We used international patient su...

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Detalhes bibliográficos
Autores: Mahil, Satveer K.|||0000-0003-4692-3794, Yates, Mark, Langan, Sinead M.|||0000-0002-7022-7441, Yiu, Zenas Z.N.|||0000-0002-1831-074X, Tsakok, Teresa|||0000-0003-1895-6070, Dand, Nick|||0000-0002-1805-6278, Mason, Kayleigh J.|||0000-0002-5419-0669, McAteer, Helen|||0000-0002-2887-5533, Meynell, Freya, Coker, Bolaji, Vincent, Alexandra, Urmston, Dominic, Vesty, Amber, Kelly, Jade, Lancelot, Camille, Moorhead, Lucy, Bachelez, Hervé|||0000-0002-2845-4384, Bruce, Ian, Capon, Francesca|||0000-0003-2432-5793, Contreras, Claudia Romina|||0000-0002-1465-5126, Cope, Andrew P., De La Cruz, Claudia|||0000-0002-8925-0457, Di Meglio, Paola|||0000-0002-2066-7780, Gisondi, Paolo|||0000-0002-1777-9001, Hyrich, Kimme|||0000-0001-8242-9262, Jullien, Denis|||0000-0002-2995-7928, Lambert, Julien|||0000-0001-6809-1154, Marzo-Ortega, H., McInnes, Iain B., Naldi, Luigi|||0000-0002-3160-2835, Norton, Sam|||0000-0003-1714-9963, Puig Sanz, Lluís|||0000-0001-6083-0952, Sengupta, Raj, Spuls, Phyllis|||0000-0002-6035-2863, Torres, Tiago|||0000-0003-0404-0870, Warren, Richard B.|||0000-0002-2918-6481, Waweru, Hoseah, Weinman, John|||0000-0002-6786-0166, Griffiths, Christopher E.M.|||0000-0001-5371-4427, Barker, Jonathan|||0000-0002-9030-183X, Brown, Matthew A.|||0000-0003-0538-8211, Galloway, James B.|||0000-0002-1230-2781, Smith, Catherine
Formato: artículo
Fecha de publicación:2021
País:España
Recursos:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:271897
Acesso em linha:https://ddd.uab.cat/record/271897
https://dx.doi.org/urn:doi:10.1111/bjd.19755
Access Level:acceso abierto
Palavra-chave:COVID-19
Cross-Sectional Studies
Humans
Joint Diseases
Male
Pandemics
SARS-CoV-2
Descrição
Resumo:Background: Registry data suggest that people with immune-mediated inflammatory diseases (IMIDs) receiving targeted systemic therapies have fewer adverse coronavirus disease 2019 (COVID-19) outcomes compared with patients receiving no systemic treatments. Objectives: We used international patient survey data to explore the hypothesis that greater risk-mitigating behaviour in those receiving targeted therapies may account, at least in part, for this observation. Methods: Online surveys were completed by individuals with psoriasis (globally) or rheumatic and musculoskeletal diseases (RMDs) (UK only) between 4 May and 7 September 2020. We used multiple logistic regression to assess the association between treatment type and risk-mitigating behaviour, adjusting for clinical and demographic characteristics. We characterized international variation in a mixed-effects model. Results: Of 3720 participants (2869 psoriasis, 851 RMDs) from 74 countries, 2262 (60·8%) reported the most stringent risk-mitigating behaviour (classified here under the umbrella term 'shielding'). A greater proportion of those receiving targeted therapies (biologics and Janus Kinase inhibitors) reported shielding compared with those receiving no systemic therapy [adjusted odds ratio (OR) 1·63, 95% confidence interval (CI) 1·35-1·97]. The association between targeted therapy and shielding was preserved when standard systemic therapy was used as the reference group (OR 1·39, 95% CI 1·23-1·56). Shielding was associated with established risk factors for severe COVID-19 [male sex (OR 1·14, 95% CI 1·05-1·24), obesity (OR 1·37, 95% CI 1·23-1·54), comorbidity burden (OR 1·43, 95% CI 1·15-1·78)], a primary indication of RMDs (OR 1·37, 95% CI 1·27-1·48) and a positive anxiety or depression screen (OR 1·57, 95% CI 1·36-1·80). Modest differences in the proportion shielding were observed across nations. Conclusions: Greater risk-mitigating behaviour among people with IMIDs receiving targeted therapies may contribute to the reported lower risk of adverse COVID-19 outcomes. The behaviour variation across treatment groups, IMIDs and nations reinforces the need for clear evidence-based patient communication on risk-mitigation strategies and may help inform updated public health guidelines as the pandemic continues.

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