ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 0952

Outcomes of COVID-19 Infection in Patients with Primary Systemic Vasculitis and Polymyalgia Rheumatica: Results from the COVID-19 Global Rheumatology Alliance Physician Registry

Sebastian Sattui1, Richard Conway2, Michael Putman3, Andrea Seet4, Kaley Beins5, Catherine Hill6, David Liew7, Sarah Mackie8, Puja Mehta9, Lorna Neill10, Gimena Gomez11, Maria Salinas12, Federico Maldonado13, Henrique Moriz14, Samia Studart15, NAFICE ARAUJO16, Ann Knight17, Davide Rozza18, Luca Quartuccio19, Maxime Samson20, Stephane Bally21, Alexandre Maria22, Pascal Chazerain23, Rebecca Hasseli24, Ulf Müller-Ladner25, Bimba Franziska Hoyer26, Reinhard Voll27, Rita Pinheiro Torres28, Mariana Luis29, Sandra Lúcia Ribeiro30, Samar Al Emadi31, Jeffrey Sparks32, Tiffany Hsu33, Kristin D'Silva34, Naomi Patel34, Leanna Wise35, Emily Gilbert36, Maria Valenzuela-Almada37, Ali Duarte-Garcia38, Manuel Ugarte-Gil39, Emily Sirotich40, Jean Liew41, Jonathan Hausmann42, Paul Sufka43, Suleman Bhana44, Rebecca Grainger45, Wendy Costello46, Lindsay Jacobsohn47, Zara Izadi4, Anja Strangfeld48, Elsa Frazão Mateus49, Kimme Hyrich50, Laure Gossec51, Loreto Carmona52, Saskia Lawson-Tovey50, Lianne Kearsley-Fleet53, Martin Schaefer54, Milena Gianfrancesco4, Pedro Machado55, Zachary Wallace34, Jinoos Yazdany4 and Philip Robinson56, 1Hospital for Special Surgery, New York, NY, 2St. James's University Hospital, Dublin, Ireland, 3Medical College of Wisconsin, Brookfield, WI, 4University of California San Francisco, San Francisco, CA, 5Vasculitis Foundation, Kansas City, MO, 6Queen Elizabeth Hospital, Woodville, Australia, 7Austin Health, Heidelberg, Australia, 8School of Medicine, University of Leeds, Leeds, United Kingdom, 9University College London, London, United Kingdom, 10PMR GCA Scotland, Perth, United Kingdom, 11Research Unit Argentine Society of Rheumatology, Buenos Aires, Argentina, 12Hospital Privado Universitario de Córdoba, Cordoba, Argentina, 13Sanatorio Güemes, Buenos Aires, Argentina, 14Hospital das Clinicas, Universidade Federal de Pernambuco, Pernambuco, Brazil, 15HOSPITAL GERAL DE FORTALEZA, Fortaleza, Brazil, 16Instituto de ASsistencia Medica ao Servidor Publico Estadual de São Paulo, São Paulo, Brazil, 17Rheumatology, Institute of Medical Sciences, Uppsala University, Uppsala, Sweden, 18Epidemiology Research Unit, Italian Society of Rheumatology, Rome, Italy, 19Clinical Rheumatology, Department of Medicine, University of Udine, Udine, Italy, 20CHU Dijon Bourgogne, Hpital Franois Mitterrand, Dijon, Dijon, France, 21Nephrology and Dialysis Service, Metropole Savoie Hospital Center, Chambery, France, 22Department of Internal Medicine and Multiorganic Diseases, Saint-Eloi University Hospital of Montpellier, Montpellier, France, 23Department of Rheumatology and Internal Medicine, Diaconesses Croix Saint Simon Hospital, Paris, France, 24Department of Rheumatology and Clinical Immunology, Campus Kerckhoff, Justus Liebig University Giessen, Bad Nauheim, Germany., Bad Nauheim, Germany, 25JLU Giessen, Campus Kerckhoff, Dept. Rheum & Clin Immunol, Bad Nauheim, Germany, 26Universittsklinikum Schleswig-Holstein, Kiel, Germany, 27Department of Rheumatology and Clinical Immunology, University Medical Center, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany, 28Rheumatology Service, Egas Moniz Hospital, Lisboa Occidental Hospital Centre, Lisbon, Portugal, 29Department of Rheumatology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portuga, Coimbra, Portugal, 30Universidade Federal do Amazonas, Amazonas, Brazil, 31Hamad medical corporation, Doha, Qatar, 32Brigham and Women's Hospital, Boston, MA, 33Brigham and Women's Hospital, Jamaica Plain, MA, 34Massachusetts General Hospital, Boston, MA, 35LAC+USC/Keck Medicine of USC, Pasadena, CA, 36Mayo Clinic, Jacksonville, FL, 37Division of Rheumatology, Mayo Clinic, Rochester, MN, 38Mayo Clinic, Rochester, MN, 39Hospital Guillermo Almenara Irigoyen, Essalud/Universidad Científica del Sur, Lima, Peru, 40McMaster University, Hamilton, ON, Canada, 41Boston University, Boston, MA, 42Boston Children's Hospital / Beth Israel Deaconess Medical Center, Cambridge, MA, 43HealthPartners, Eagan, MN, 44Crystal Run Health, Montvale, NJ, 45University of Otago, Wellington, New Zealand, 46Irish Children's Arthritis Network, Bansha, Ireland, 47University of California San Francisco, Antioch, CA, 48Deutsches Rheuma-Forschungszentrum Berlin, Berlin, Germany, 49Liga Portuguesa Contra as Doenças Reumáticas (LPCDR), Lisbon, Portugal, 50University of Manchester, Manchester, United Kingdom, 51Sorbonne Université and Hôpital Pitié-Salpêtrière, Paris, France, 52Instituto de Salud Musculoesqueltica (InMusc), Madrid, Spain, 53Centre for Musculoskeletal Research, University of Manchester, Manchester, United Kingdom, 54German Rheumatism Research Center, Berlin, Germany, 55Centre for Rheumatology & Department of Neuromuscular Diseases, University College London, London, United Kingdom, 56University of Queensland School of Clinical Medicine, Brisbane, Queensland, Australia, Herston, Australia

Meeting: ACR Convergence 2021

Keywords: , , , ,

Session Information

Date: Sunday, November 7, 2021

Title: Abstracts: Vasculitis – ANCA-Associated (0952–0955)

Session Type: Abstract Session

Session Time: 9:00AM-9:15AM

Background/Purpose: Patients with primary systemic vasculitis (PSV) and polymyalgia rheumatica (PMR) may be at high risk for poor COVID-19 outcomes due to the treatments used, the potential organ damage caused by PSV, and demographic factors such as older age that are associated with these conditions. We investigated factors associated with COVID-19 outcomes in patients with PSV and PMR in a large multinational registry.

Methods: We analyzed PSV and PMR cases from the COVID-19 Global Rheumatology Alliance registries (12/Mar/2020-12/Apr/2021). PSV diagnoses included ANCA vasculitis (AAV), giant cell arteritis (GCA), Behçet’s syndrome, and other vasculitides. The ordinal COVID-19 severity outcome was: 1) no hospitalization, 2) hospitalization without oxygen, 3) hospitalization with oxygen/ventilation, or 4) death. Relevant covariates included age, sex, race, season, number of comorbidities, BMI, smoking status, disease activity, immunosuppresive therapies (conventional synthetic and biologic/targeted synthetic DMARDs), glucocorticoid (GC) (daily dose prednisolone-equivalent), and region. Multivariable ordinal logistic regressions were used to estimate odds ratios (ORs) for being one level higher on the ordinal outcome. Analyses were also stratified by disease (GCA, AAV, or PMR).

Results: Of 1,202 included patients, 61.0% were female; mean age was 63.8 years. Diagnoses were PMR (31.1%), AAV (29.3%), GCA (15.2%), Behçet’s syndrome (9.4%), and other vasculitis (15.0%). Overall, 508 (49.8%) patients were hospitalized, and 155 (15.2%) patients died (Table 1). Older age (OR 1.46, 95% CI 1.33-1.60), male sex (OR 1.46, 95% CI 1.12-1.91), GC dose ≥ 10 mg/day (OR 2.14, 95% CI 1.48-3.09), moderate/severe or high disease activity (OR 2.32, 95% CI 1.60-3.36) and number of comorbidities (OR 1.38, 95% CI 1.22-1.57) were associated with worse outcome (Table 2). In the disease-specific stratified analysis, 20.3% and 22.2% of patients with GCA and AAV, respectively, died. Risk factors for poorer outcomes were: for GCA patients, older age (OR 1.79, 95% CI 1.21-2.65) and obesity (OR 3.04, 95% CI 1.17-3.04); for AAV patients, older age (OR 1.45, 95% CI 1.18-1.79), rituximab (OR 2.50, 95% CI 1.33-4.68) or cyclophosphamide use (OR 6.43, 95% CI 1.48-28.01), and moderate/severe or high disease activity (OR 2.71, 95% CI 1.21-6.07); and for polymyalgia rheumatica, older age (OR 2.69, 95% CI 1.99-3.63) and higher comorbidity burden (OR 1.31, 95% CI 1.03-1.67). Overall, severe outcomes were less likely if COVID-19 infection developed between October 1, 2020, and April 12, 2021 (OR 0.47, 95% CI 0.35-0.63). This was also observed in the disease-specific analysis.

Conclusion: Patients with GCA or AAV who had COVID-19 infection had higher rates of severe outcomes compared to PMR and other vasculitis, even despite similar ages of the GCA and PMR groups. Risk factors identified for different PSV subtypes may inform mitigation strategies for these patients.

Figure 1.

Table 1.

Table 2.

Disclosures: S. Sattui, None; R. Conway, Janssen, 6, Sanofi, 6, Roche, 6, Abbvie, 6; M. Putman, None; A. Seet, None; K. Beins, Bristol Myers Squibb, 6; C. Hill, None; D. Liew, None; S. Mackie, Roche, 2, Sanofi, 2, UK Medical Research Council (MRC) TARGET Partnership Grant (MR/N011775/1/MRC_/Medical Research Council/United Kingdom), 5, UK National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, 5; P. Mehta, GSK, 5, SOBI, 1, Lilly, 6; L. Neill, None; G. Gomez, None; M. Salinas, None; F. Maldonado, None; H. Moriz, None; S. Studart, None; N. ARAUJO, Boehringer Ingelheim, 6, GlaxoSmithKline, 2, Janssen, 2, Novartis, 2, Amgen, 2; A. Knight, None; D. Rozza, None; L. Quartuccio, None; M. Samson, None; S. Bally, None; A. Maria, None; P. Chazerain, None; R. Hasseli, Pfizer, Medac, Amgen, Galapagos, Novartis, Roche, Takeda, BMS, Janssen, 1, 5; U. Müller-Ladner, Biogen, 6; B. Hoyer, Pfizer, 1, 6, Abbvie, 6, UCB, 6; R. Voll, None; R. Torres, None; M. Luis, None; S. Ribeiro, None; S. Al Emadi, None; J. Sparks, Bristol-Myers Squibb, 2, 5, Amgen, 5, Gilead, 2, Inova, 2, Janssen, 2, Optum, 2, Pfizer, 2; T. Hsu, None; K. D'Silva, None; N. Patel, None; L. Wise, None; E. Gilbert, None; M. Valenzuela-Almada, None; A. Duarte-Garcia, None; M. Ugarte-Gil, Pfizer, 5, Janssen, 5; E. Sirotich, None; J. Liew, None; J. Hausmann, Novartis, 2, Biogen, 2, Pfizer, 2; P. Sufka, Wiley Publishing, 6; S. Bhana, Amgen, 1, Novartis, 1, Horizon, 1, Pfizer, 1, AbbVie, 1; R. Grainger, Pfizer New Zealand, 6, 12, support to travel to conference, Jansenn Autralia, 6, 12, travel to symposia, AbbVie New Zealand, 6, Cornerstones, 6, novartis, 1; W. Costello, None; L. Jacobsohn, None; Z. Izadi, None; A. Strangfeld, Pfizer, 6, Roche, 6, MSD, 6, BMS, 6, Abbvie, 6, Celltrion, 6; E. Frazão Mateus, Boehringer Ingelheim, 6, Pfizer, 5, 12, Non-financial, Lilly Portugal, 5, Sanofi, 5, AbbVie, 5, Novartis, 5, Grünenthal. SA., 5, MSD, 5, Celgene, 5, Medac, 5, Janssen-Cilag, 5, Pharmakern, 5, GAfPA, 5; K. Hyrich, Abbvie, 6, Pfizer, 5, BMS, 5; L. Gossec, Galapagos, 5, Sandoz, 5, Sanofi, 5, AbbVie, 2, Amgen, 2, 5, Bristol Myers Squibb, 2, Biogen, 2, Celgene, 2, Eli Lilly, 2, 5, Gilead, 2, Janssen, 2, 5, Novartis, 2, Pfizer, 2, 5, Samsung Bioepis, 2, Sanofi-Aventis, 2, UCB, 2; L. Carmona, None; S. Lawson-Tovey, None; L. Kearsley-Fleet, None; M. Schaefer, None; M. Gianfrancesco, None; P. Machado, Abbvie, 6, BMS, 6, Celgene, 6, Eli Lilly, 2, Janssen, 2, MSD, 6, Galapagos, 6, Novartis, 2, 6, Pfizer, 6, Roche, 6, UCB, 2, 6, Orphazyme, 5, 6; Z. Wallace, Bristol-Myers Squibb, 5, Principia/Sanofi, 5, Viela Bio, 2, MedPace, 2; J. Yazdany, Astra Zeneca, 2, 5, Pfizer, 2, 6, Gilead, 5, BMS Foundation, 5; P. Robinson, Abbvie, 1, Novartis, 1, 5, 6, Atom Biosciences, 1, Janssen, 5, 6, Eli Lilly, 1, 2, 6, Gilead, 6, UCB Pharma, 1, 5, 6, Pfizer, 1, 5, 6, Roche, 6.

To cite this abstract in AMA style:

Sattui S, Conway R, Putman M, Seet A, Beins K, Hill C, Liew D, Mackie S, Mehta P, Neill L, Gomez G, Salinas M, Maldonado F, Moriz H, Studart S, ARAUJO N, Knight A, Rozza D, Quartuccio L, Samson M, Bally S, Maria A, Chazerain P, Hasseli R, Müller-Ladner U, Hoyer B, Voll R, Torres R, Luis M, Ribeiro S, Al Emadi S, Sparks J, Hsu T, D'Silva K, Patel N, Wise L, Gilbert E, Valenzuela-Almada M, Duarte-Garcia A, Ugarte-Gil M, Sirotich E, Liew J, Hausmann J, Sufka P, Bhana S, Grainger R, Costello W, Jacobsohn L, Izadi Z, Strangfeld A, Frazão Mateus E, Hyrich K, Gossec L, Carmona L, Lawson-Tovey S, Kearsley-Fleet L, Schaefer M, Gianfrancesco M, Machado P, Wallace Z, Yazdany J, Robinson P. Outcomes of COVID-19 Infection in Patients with Primary Systemic Vasculitis and Polymyalgia Rheumatica: Results from the COVID-19 Global Rheumatology Alliance Physician Registry [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/outcomes-of-covid-19-infection-in-patients-with-primary-systemic-vasculitis-and-polymyalgia-rheumatica-results-from-the-covid-19-global-rheumatology-alliance-physician-registry/. Accessed .

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