COVID-19 COURSE AND OUTCOME IN PATIENTS WITH INFLAMMATORY RHEUMATIC DISEASES WHO ARE ON BIOLOGICAL OR TARGETED SYNTHETIC DISEASE-MODIFYING ANTIRHEUMATIC DRUGS – RESULTS FROM A SINGLE RHEUMATOLOGY CENTRE

Stipe Ćavar, Frane Grubišić, Hana Skala Kavanagh, Ines Doko Vajdić, Simeon Grazio

The aim of this study was to investigate the course and outcome of COVID in patients with inflammatory rheumatic diseases (IRD) who are on biological disease-modifying antirheumatic drugs (bDMARDs) or targeted synthetic disease-modifying antirheumatic drugs (tsDMARDs). In this study, we used the data of patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) who had been treated at the Department of Rheumatology, Physical and Rehabilitation Medicine of the Sestre milosrdnice University Hospital in Zagreb (Croatia) and in whose case the SARS-CoV-2 infection was proven in the period from February 2020 until the end of July 2021. In order to analyse this data, we have used the methods of descriptive statistics. Out of a total of 28 patients, 6 had a severe or critical case of COVID-19, but only one subject was hospitalized. All 6 patients were treated with bDMARDs before the onset of infection. Most of them (4/6) had moderate to high disease activity of IRD, as well as multiple comorbidities. No deaths were recorded in this cohort of patients. The results of this study suggest that the course of COVID-19 is associated with the disease activity of IRD and accompanying comorbidities, whereas the use of specific biological drugs might be associated with a more favourable outcome of the infection. Therefore, a better follow-up process and management of disease activity in patients with IRD should be implemented during the period of this pandemic, as well as the modification of specific therapy.

Cilj ovog istraživanja bio je istražiti tijek i ishod bolesti COVID-19 kod ispitanika s upalnim reumatskim bolestima koji su liječeni biološkim lijekovima koji mijenjaju tijek bolesti (engl. biologic disease modifying antirheumatic drugs, skr. bDMARDs) i ciljanim sintetskim lijekovima koji mijenjaju tijek bolesti (engl. targeted synthetic disease modifying antitheumatic drugs, skr. tsDMARDs). U istraživanju smo analizirali podatke bolesnika s reumatoidnim artritisom (RA), psorijatičnim artritisom (PsA) i aksijalnim spondiloartritisom (axSpA) koji su se kontrolirali na Klinici za reumatologiju, fizikalnu medicinu i rehabilitaciju Kliničkoga bolničkog centra Sestre milosrdnice u Zagrebu i koji su imali dokazanu infekciju virusom SARS-CoV-2 u razdoblju od veljače 2020. do kraja srpnja 2021. godine. Od ukupno 28 bolesnika njih šestoro je imalo teški ili kritični oblik bolesti COVID-19, a samo jedna osoba je bila hospitalizirana. Svih tih šest bolesnika bilo je liječeno bDMARDs-ima. Većina bolesnika (4 od 6) s teškim i kritičnim oblikom bolesti COVID-19 imali su umjereni do visoki stupanj aktivnosti upalne reumatske bolesti, kao i više komorbiditeta. Smrtnog ishoda u ovoj kohorti bolesnika nije bilo. Rezultati ovog istraživanja sugeriraju da je tijek bolesti COVID-19 povezan sa stupnjem aktivnosti upalne reumatske bolesti i popratnim komorbiditetima, a mogući povoljniji ishod s upotrebom specifične biološke terapije. Stoga je u ovo doba pandemije potrebna bolja kontrola aktivnosti upalne reumatske bolesti, kao i modifikacija specifične terapije.