AB1193 THE COURSE OF COVID-19 INFECTION IN PATIENTS WITH RHEUMATOID ARTHRITIS RECEIVING VARIOUS BIOLOGICAL DISEASE-MODIFYING ANTIRHEUMATIC DRUGS

Abstract

BackgroundWith the ongoing COVID-19 pandemic, the safety of biologic disease-modifying antirheumatic drugs in patients with rheumatic disease remains an important issue.Objectivesto assess the course of COVID-19 infection in patients with rheumatoid arthritis receiving various biological disease-modifying antirheumatic drugs.MethodsAn analysis was made of the course of COVID-19 in patients with rheumatic diseases who were under observation at the North-Western State Medical University. I.I. Mechnikov in the period from March 2020 to November 2021. During this period, 198 (14.04%) cases of COVID-19 were registered out of 1389 patients included in the registries of the anticytokine therapy center. Among patients with rheumatoid arthritis who recovered from COVID-19 infection, 105 cases were registered, of which 53 patients received outpatient treatment, and 52 patients received inpatient treatment. In 76% of cases, patients received biological DMARDs in combination with synthetic DMARDs.ResultsExacerbation of the articular syndrome was observed only in 12 (11.4%) patients with RA during COVID-19. The low percentage of exacerbations in patients with RD on the background of COVID-19 was probably associated with the use of dexamethasone at a dose of 16-32 mg, which has the ability to reduce the activity of the immune-inflammatory process in rheumatic diseases. This statement is confirmed by the fact that out of 52 patients with RA who were hospitalized for COVID-19, 16 patients (30.8%) received dexamethasone intramuscularly or intravenously, and 8 patients (15.4%) continued oral administration of this drug.Table 1.The course of COVID-19 infection in RA patients treated with various biological DMARDs.Severity and outcomes of COVID-19All patients (n=105)N (%)Abatacept (n=11)N (%)Rituximab (n=56)N (%)IL-6 inhibitors (n=9)N (%)TNF-alpha inhibitors n=15 N (%)JAK inhibitors n=17 N (%)No hospitalization required53 (50,5)3 (27,3)19 (33,9)8 (88,9)12 (80)11 (64,7)Hospitalization without oxygen support31 (29,5)5 (45,5)18 (32,1)1 (11,1)3 (20)4 (23,5)Hospitalization with oxygenation or mechanical ventilation24 (22,8)3 (27,3)19 (33,9)002 (11,8)Death5 (4,8)1 (9,1)4 (7,1)000ConclusionThe use of rituximab was associated with a more severe course of COVID-19, which required hospitalization in 66% of cases, compared with the group of patients treated with TNF-α inhibitors, in which hospital treatment was carried out only in 20% of cases. The introduction of blockers of co-stimulation of T-cells, IL-6 inhibitors, targeted synthetic drugs did not affect the severity of COVID-19.Disclosure of InterestsNone declared