Mahil, SK; Yates, M; Langan, SM; Yiu, ZZN; Tsakok, T; Dand, N; Mason, KJ; McAteer, H; Meynell, F; Coker, B; +34 more... Vincent, A; Urmston, D; Vesty, A; Kelly, J; Lancelot, C; Moorhead, L; Bachelez, H; Bruce, IN; Capon, F; Contreras, CR; Cope, AP; De La Cruz, C; Di Meglio, P; Gisondi, P; Hyrich, K; Jullien, D; Lambert, J; Marzo-Ortega, H; McInnes, I; Naldi, L; Norton, S; Puig, L; Sengupta, R; Spuls, P; Torres, T; Warren, RB; Waweru, H; Weinman, J; Griffiths, CEM; Barker, JN; Brown, MA; Galloway, JB; Smith, CH; PsoProtect, CORE-UK study groups; (2020) Risk-mitigating behaviours in people with inflammatory skin and joint disease during the COVID-19 pandemic differ by treatment type: a cross-sectional patient survey. The British journal of dermatology, 185 (1). pp. 80-90. ISSN 0007-0963 DOI: https://doi.org/10.1111/bjd.19755
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Abstract
BACKGROUND: Registry data suggest that people with immune-mediated inflammatory diseases (IMIDs) receiving targeted systemic therapies have fewer adverse coronavirus disease 2019 (COVID-19) outcomes compared with patients receiving no systemic treatments. OBJECTIVES: We used international patient survey data to explore the hypothesis that greater risk-mitigating behaviour in those receiving targeted therapies may account, at least in part, for this observation. METHODS: Online surveys were completed by individuals with psoriasis (globally) or rheumatic and musculoskeletal diseases (RMDs) (UK only) between 4 May and 7 September 2020. We used multiple logistic regression to assess the association between treatment type and risk-mitigating behaviour, adjusting for clinical and demographic characteristics. We characterized international variation in a mixed-effects model. RESULTS: Of 3720 participants (2869 psoriasis, 851 RMDs) from 74 countries, 2262 (60·8%) reported the most stringent risk-mitigating behaviour (classified here under the umbrella term 'shielding'). A greater proportion of those receiving targeted therapies (biologics and Janus Kinase inhibitors) reported shielding compared with those receiving no systemic therapy [adjusted odds ratio (OR) 1·63, 95% confidence interval (CI) 1·35-1·97]. The association between targeted therapy and shielding was preserved when standard systemic therapy was used as the reference group (OR 1·39, 95% CI 1·23-1·56). Shielding was associated with established risk factors for severe COVID-19 [male sex (OR 1·14, 95% CI 1·05-1·24), obesity (OR 1·37, 95% CI 1·23-1·54), comorbidity burden (OR 1·43, 95% CI 1·15-1·78)], a primary indication of RMDs (OR 1·37, 95% CI 1·27-1·48) and a positive anxiety or depression screen (OR 1·57, 95% CI 1·36-1·80). Modest differences in the proportion shielding were observed across nations. CONCLUSIONS: Greater risk-mitigating behaviour among people with IMIDs receiving targeted therapies may contribute to the reported lower risk of adverse COVID-19 outcomes. The behaviour variation across treatment groups, IMIDs and nations reinforces the need for clear evidence-based patient communication on risk-mitigation strategies and may help inform updated public health guidelines as the pandemic continues.
Item Type | Article |
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Faculty and Department | Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology |
Research Centre | Covid-19 Research |
PubMed ID | 33368145 |
Elements ID | 155135 |
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