Table 3.
Exploratory Analyses of Specific Medication Exposures and Any Severe COVID-19 Outcome
| Number of outcomes/numberof cases | Adjusted OR (95% CI) N = 3977 |
|
|---|---|---|
| Original analysis (Table2) | ||
| No immune-mediated medication | 3723/38,406 | Ref |
| Prednisone | 197/958 | 1.31 (1.08–1.60) |
| Immunomodulator | 83/327 | 0.88 (0.57–1.34) |
| Small-molecule/biologic therapy | 36/193 | 1.26 (0.79–2.00) |
| Short-term vs longer prednisone* | ||
| No immune-mediated medication | 3723/38,406 | Ref |
| Short-term prednisone (< 7 days) | 62/432 | 1.08 (0.80–1.48) |
| Longer prednisone (≥ 7 days) | 123/491 | 1.49 (1.15–1.93) |
| Immunomodulator | 83/327 | 0.85 (0.56–1.31) |
| Small-molecule/biologic therapy | 36/193 | 1.25 (0.78–1.98) |
| Monotherapy vs combination therapy | ||
| No immune-mediated medication | 3723/38,406 | Ref |
| Monotherapy | ||
| Prednisone | 149/821 | 1.25 (1.01–1.54) |
| Immunomodulator | 34/167 | 0.76 (0.46–1.27) |
| Small molecule/biologic | 16/115 | 0.82 (0.43–1.55) |
| Combination therapy | ||
| Prednisone + immunomodulator | 35/99 | 1.12 (0.56–2.25) |
| Prednisone + small molecule/biologic | 6/17 | 3.57 (1.17–10.85) |
| Immunomodulator + small molecule/biologic | 7/40 | 1.17 (0.45–3.04) |
| All three | 7/21 | 2.99 (0.94–9.49) |
| Selected medication groupings | ||
| No immune-mediated medication | 3723/38,406 | Ref |
| Prednisone | 197/958 | 1.27 (1.04–1.55) |
| Thiopurines/traditional DMARDs† | 34/220 | 0.53 (0.32–0.88) |
| Anti-TNF | 7/94 | 0.45 (0.18–1.08) |
| JAK-I | 7/23 | 3.35 (1.16–9.67) |
| Other therapies used only in immune-mediated inflammatory disease†† | 9/66 | 0.83 (0.37–1.89) |
| Other therapies used also in other diseases (i.e., transplant, cancer)§ | 60/129 | 3.84 (2.01–7.35) |
All models adjust for patient age, sex, race/ethnicity, body mass index, immune-mediated disease (asthma, inflammatory bowel disease, organ transplantation, psoriasis, rheumatoid arthritis, spondyloarthropathy, lupus), hypertension, Charlson comorbidity score, and week of SARS-CoV-2-positive lab test. Therapies with at least 1 patient are listed
*35 patients missing length of prednisone
†Azathioprine, 6-mercaptopurine, methotrexate, hydroxychloroquine, leflunomide
††Apremilast, tocilizumab, ustekinumab, guselkumab, secukinumab, vedolizumab, belimumab, abatacept
§Cyclosporine, tacrolimus, everolimus, cyclophosphamide, mycophenolate, rituximab