fetching data ... 
Background: With the ongoing COVID-19 pandemic, the safety of biologic disease-modifying antirheumatic drugs in patients with rheumatic disease remains an important issue.
Objectives: to assess the course of COVID-19 infection in patients with rheumatoid arthritis receiving various biological disease-modifying antirheumatic drugs.
Methods: An 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.
Results: Exacerbation 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.
The course of COVID-19 infection in RA patients treated with various biological DMARDs.
| Severity and outcomes of COVID-19 | All 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 required | 53 (50,5) | 3 (27,3) | 19 (33,9) | 8 (88,9) | 12 (80) | 11 (64,7) |
| Hospitalization without oxygen support | 31 (29,5) | 5 (45,5) | 18 (32,1) | 1 (11,1) | 3 (20) | 4 (23,5) |
| Hospitalization with oxygenation or mechanical ventilation | 24 (22,8) | 3 (27,3) | 19 (33,9) | 0 | 0 | 2 (11,8) |
| Death | 5 (4,8) | 1 (9,1) | 4 (7,1) | 0 | 0 | 0 |
Conclusion: The 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 Interests: None declared