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September 14, 2021
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Biologics not associated with COVID-19 risk or mortality

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COVID-19 mortality was not increased in patients on immunosuppressive biologics, according to a study.

“The COVID-19 pandemic raised concerns about management of patients with immune-mediated inflammatory diseases treated with immunosuppressive biologics,” Vartan Pahalyants, MD, MBA, from the department of dermatology at Massachusetts General Hospital, and colleagues wrote.

COVID data
COVID-19 mortality was not increased in patients on immunosuppressive biologics.

“As population level analyses of this patient group remain limited, we compared COVID-19 incidence and subsequent mortality in a large cohort of patients prescribed biologics and matched controls.”

The retrospective matched cohort study, detailed in a brief report in the Journal of the American Academy of Dermatology, included 7,361 patients who received biologics and 74,910 matched controls.

The most frequently prescribed biologics were adalimumab (28.4%), infliximab (15.6%), rituximab (15.6%), etanercept (11.9%) and dupilumab (8.6%). The most common indications for biologics were rheumatoid arthritis (27.5%), psoriasis (27.3%), psoriatic arthritis (16.2%), Crohn’s disease (24.9%) and ulcerative colitis (18.9%).

COVID-19 infection rates were not associated with biologic use (OR = 0.88; 95% CI, 0.71-1.09). Mortality rates — adjusted for demographics, comorbidity burden and local infection rates — were similar between those taking biologics and the matched controls (OR = 1.13; 95% CI, 0.57-2.76).

In addition, those treated with TNF inhibitors (adalimumab, infliximab and etanercept) had a lesser chance to contract COVID-19 (OR = 0.69; 95% CI, 0.48-098; P = 0.04).

“Despite the ongoing vaccination efforts, COVID-19 remains a top health concern. The major finding of our study is that biologics did not increase the risk of positive COVID-19 diagnosis ... Furthermore, we did not identify an association between biologics and mortality,” the authors wrote.