ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 0097

Outcome of SARS-CoV-2 Infection in Patients with Rheumatoid Arthritis Under Treatment with Janus Kinase Inhibitors Compared to Tumour Necrosis Factor Inhibitors

Rebecca Hasseli1, Bimba Franziska Hoyer2, Hanns-Martin Lorenz3, Alexander Pfeil4, Anne Regierer5, Jutta Richter6, Tim Schmeiser7, Anja Strangfeld8, Reinhard Voll9, Andreas Krause10, Hendrik Schulze-Koops11, Christof Specker12 and Ulf Müller-Ladner13, 1Justus-Liebig-University Giessen, Bad Nauheim, Germany, 2Universittsklinikum Schleswig-Holstein, Kiel, Germany, 3University Hospital Heidelberg Germany, Heidelberg, Germany, 4Friedrich Schiller University Jena, Jena, Germany, 5German Rheumatism Research Center, Berlin, Germany, 6Rheumatology and Hiller Research Unit, Heinrich-Heine-University Duesseldorf, Medical Faculty, Duesseldorf, Germany, 7Private Practice, Cologne, Germany, 8Deutsches Rheuma-Forschungszentrum Berlin, Berlin, Germany, 9Department of Rheumatology and Clinical Immunology, University Medical Center, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany, 10Immanuel Hospital, Berlin, Germany, 11Division of Rheumatology and Clinical Immunology, Department of Internal Medicine IV, University of Munich, Munich, Germany, 12Evangelisches Krankenhaus, Kliniken Essen-Mitte, Essen, Germany, 13JLU Giessen, Campus Kerckhoff, Dept. Rheum & Clin Immunol, Bad Nauheim, Germany

Meeting: ACR Convergence 2021

Keywords: , , , ,

Session Information

Date: Saturday, November 6, 2021

Title: Epidemiology & Public Health Poster I: COVID-19 & Vaccination (0084–0117)

Session Type: Poster Session A

Session Time: 8:30AM-10:30AM

Background/Purpose: Janus kinase inhibitors (JAK-i) offer a potent mode of action to treat rheumatic diseases. Little is known on the course and outcome of SARS-CoV-2 infections in RA patients treated with JAK-i. The aim of this study is to describe the outcome of SARS-CoV-2 infection in RA patients treated with JAK-i in comparison to patients treated with TNF-inhibitors (TNF-i).

Methods: In the German COVID-19 registry for inflammatory rheumatic diseases, the course and outcome of proven SARS-CoV-2 infections are documented by treating rheumatologists. From March 30th, 2020 until April 5th, 2021 a total of 2253 cases was collected. 982 were reported with RA, of which 128 were treated with JAK-i and 190 with TNF-i. Patient characteristics and outcome of the SARS-CoV-2 infection were analysed descriptively. Differences in characteristics were tested by the Pearson Chi-Square-Test.

Results: Median age in both treatment groups was comparable (tab.1). Concomitant glucocorticoids (GC) were used in 50% of the JAK-i and 31% of the TNF-i patients (p < 0.001). Additional conventional synthetic (cs) disease-modifying anti-rheumatic drugs (DMARD) were used in 29% of the JAK-i and in 49% of the TNF-i patients (p < 0.001). Moderate and high disease activity before acquisition of the infection was more frequently reported in JAK-i patients than under TNF-i treatment (p=0.042). Comorbidities that were recently found to be associated with a higher risk of hospitalisation and death, namely cardiovascular disease and hypertension were also more frequent in patients with JAK-i. Hospitalisation due to COVID-19 was necessary for 33% of patients treated with JAK-i and 13% of patients treated with TNF-i , and oxygen treatment was required in 25% and 7% of the patients, respectively (p < 0.001). Eight versus none (p < 0.001) fatal cases were reported in the JAK-i versus the TNF-i group.

Conclusion: The higher rate of hospitalisation and death among RA patients treated with JAK-i compared to TNF-i is remarkable. However, this has to be interpreted with caution, since RA patients under JAK-i harboured some differences in potentially confounding RA-related and unrelated factors like disease activity, concomitant use of GCs, and certain comorbidities. To address this, further analyses with adjustments for baseline differences should follow.

Table 1: Characteristics of JAK-i and TNF-i treated patients with SARS-CoV_2 infections

Disclosures: R. Hasseli, Pfizer, Novartis, Medac, Abbvie, Galapagos, BMS, Biogen, Takeda, Roche/Chugai, Janssen, Amgen, 1, 2, 6, Pfizer, 5; B. Hoyer, Pfizer, 1, 6, Abbvie, 6, UCB, 6; H. Lorenz, None; A. Pfeil, None; A. Regierer, None; J. Richter, Abbvie, 2, Lilly, 2, 6, Pfizer, 6, Sanofi, 2, 6; T. Schmeiser, None; A. Strangfeld, Pfizer, 6, Roche, 6, MSD, 6, BMS, 6, Abbvie, 6, Celltrion, 6; R. Voll, None; A. Krause, None; H. Schulze-Koops, Roche/Chugai, 2, 5, 6, Sobi, 6, Novartis, 2, 5, 6, AbbVie, 2, 5, 6, Amgen, 2, 6, Bristol-Myers Squibb, 2, 6, Celgene, 2, 6, Celltrion, 2, 6, Chugai, 2, 6, Gilead Sciences, 2, 6, Janssen, 2, 6, Eli Lilly, 2, 6, MSD, 2, 6, Pfizer Inc, 2, 6, Sanofi, 2, 6, Galapagos, 1, 2, UCB, 1, 2; C. Specker, AbbVie, 1, 6, Boehringer, 1, 6, Chugai, 2, 6, GSK, 1, 6, Lilly, 6, MSD, 6, Novartis, 1, 6, Pfizer, 6, Roche, 6, Sanofi, 6, Sobi, 1, 6; U. Müller-Ladner, Biogen, 6.

To cite this abstract in AMA style:

Hasseli R, Hoyer B, Lorenz H, Pfeil A, Regierer A, Richter J, Schmeiser T, Strangfeld A, Voll R, Krause A, Schulze-Koops H, Specker C, Müller-Ladner U. Outcome of SARS-CoV-2 Infection in Patients with Rheumatoid Arthritis Under Treatment with Janus Kinase Inhibitors Compared to Tumour Necrosis Factor Inhibitors [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/outcome-of-sars-cov-2-infection-in-patients-with-rheumatoid-arthritis-under-treatment-with-janus-kinase-inhibitors-compared-to-tumour-necrosis-factor-inhibitors/. Accessed .

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