Considerations for Pharmacologic Management of Rheumatoid Arthritis in the COVID-19 Era: a Narrative Review

Conway R, Grimshaw AA, Konig MF, et al. SARS–CoV-2 infection and COVID-19 outcomes in rheumatic diseases: a systematic literature review and meta-analysis. Arthritis Rheumatol. 2022;74:766–75.

Article  CAS  PubMed  PubMed Central  Google Scholar 

England BR, Roul P, Yang Y, Kalil AC, Michaud K, Thiele GM, Sauer BC, Baker JF, Mikuls TR. Risk of COVID-19 in rheumatoid arthritis: a national veterans affairs matched cohort study in at-risk individuals. Arthritis Rheumatol. 2021;73:2179–88.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Figueroa-Parra G, Gilbert EL, Valenzuela-Almada MO, et al. Risk of severe COVID-19 outcomes associated with rheumatoid arthritis and phenotypic subgroups: a retrospective, comparative, multicentre cohort study. Lancet Rheumatol. 2022;4:e765–74.

Article  CAS  PubMed  PubMed Central  Google Scholar 

• Sparks JA, Wallace ZS, Seet AM, et al. Associations of baseline use of biologic or targeted synthetic DMARDs with COVID-19 severity in rheumatoid arthritis: results from the COVID-19 Global Rheumatology Alliance physician registry. Ann Rheum Dis. 2021;80:1137–46. This was an early pandemic study with a large sample size of patients with RA that found that rituximab and JAK inhibitors were associated with worse COVID-19 severity compared to TNF inhibitors

Article  CAS  PubMed  Google Scholar 

Zaccardelli A, Wallace ZS, Sparks JA. Acute and postacute COVID-19 outcomes for patients with rheumatoid arthritis: lessons learned and emerging directions 3 years into the pandemic. Curr Opin Rheumatol. 2023;35:175–84.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Sun J, Zheng Q, Madhira V, et al. Association between immune dysfunction and COVID-19 breakthrough infection after SARS-CoV-2 vaccination in the US. JAMA Intern Med. 2022;182:153.

Article  CAS  PubMed  Google Scholar 

Cook C, Cox H, Fu X, Zhang Y, Stone JH, Choi HK, Wallace ZS. Perceived risk and associated shielding behaviors in patients with rheumatoid arthritis during the coronavirus 2019 pandemic. ACR Open Rheumatol. 2021;3:834–41.

Article  PubMed  PubMed Central  Google Scholar 

Avouac J, Drumez E, Hachulla E, et al. COVID-19 outcomes in patients with inflammatory rheumatic and musculoskeletal diseases treated with rituximab: a cohort study. Lancet Rheumatol. 2021;3:e419–26. This was one of the first studies that established rituximab's association with severe COVID-19 in patients with inflammatory rheumatic and musculoskeletal diseases

Article  CAS  PubMed  PubMed Central  Google Scholar 

Wallace ZS, Bhana S, Hausmann JS, Robinson PC, Sufka P, Sirotich E, Yazdany J, Grainger R. The Rheumatology Community responds to the COVID-19 pandemic: the establishment of the COVID-19 global rheumatology alliance. Rheumatology. 2020;59:1204–6.

Article  PubMed  Google Scholar 

Singh N, Madhira V, Hu C, Olex AL, Bergquist T, Fitzgerald KC, Huling JD, Patel RC, Singh JA. Rituximab is associated with worse COVID-19 outcomes in patients with rheumatoid arthritis: a retrospective, nationally sampled cohort study from the U.S. National COVID Cohort Collaborative (N3C). Semin Arthritis Rheum. 2023;58:152149.

Article  CAS  PubMed  Google Scholar 

D’Silva KM, Serling-Boyd N, Hsu TY-T, Sparks JA, Wallace ZS. SARS-CoV-2 antibody response after COVID-19 in patients with rheumatic disease. Ann Rheum Dis. 2021;80:817–9.

Article  PubMed  Google Scholar 

Izadi Z, Brenner EJ, Mahil SK, et al. Association between tumor necrosis factor inhibitors and the risk of hospitalization or death among patients with immune-mediated inflammatory disease and COVID-19. JAMA Netw Open. 2021;4:e2129639. This large study pooled data from rheumatology, psoriasis, and inflammatory bowel disease COVID-19 registries and found that TNFi had lower odds of severe COVID-19 compared to alternative therapies.

Article  PubMed  PubMed Central  Google Scholar 

Gianfrancesco M, Hyrich KL, Al-Adely S, et al. Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry. Ann Rheum Dis. 2020;79:859–66.

Article  CAS  PubMed  Google Scholar 

Kaneko N, Kuo H-H, Boucau J, et al. Loss of Bcl-6-expressing t follicular helper cells and germinal centers in COVID-19. Cell. 2020;183:143–157.e13.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Piscoya A, Parra del Riego A, Cerna-Viacava R, Rocco J, Roman YM, Escobedo AA, Pasupuleti V, White CM, Hernandez AV. Efficacy and harms of tocilizumab for the treatment of COVID-19 patients: a systematic review and meta-analysis. PLOS ONE. 2022;17:e0269368.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Ko ER, Anstrom KJ, Panettieri RA, et al. Abatacept for treatment of adults hospitalized with moderate or severe Covid-19. 2022; https://doi.org/10.1101/2022.09.22.22280247.

O’Halloran JA, Kedar E, Anstrom KJ, et al. Infliximab for treatment of adults hospitalized with moderate or severe Covid-19. 2022; https://doi.org/10.1101/2022.09.22.22280245.

Bower H, Frisell T, Di Giuseppe D, et al. Impact of the COVID-19 pandemic on morbidity and mortality in patients with inflammatory joint diseases and in the general population: a nationwide Swedish cohort study. Ann Rheum Dis. 2021;80:1086–93.

Article  CAS  PubMed  Google Scholar 

Curtis JR, Zhou X, Rubin DT, Reinisch W, Yazdany J, Robinson PC, Chen Y, Benda B, Madsen A, Geier J. Characteristics, comorbidities, and outcomes of SARS-CoV-2 infection in patients with autoimmune conditions treated with systemic therapies: a population-based study. J Rheumatol. 2022;49:320–9.

Article  CAS  PubMed  Google Scholar 

Abani O, Abbas A, Abbas F, et al. Baricitinib in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial and updated meta-analysis. Lancet. 2022;400:359–68.

Article  Google Scholar 

Strangfeld A, Schäfer M, Gianfrancesco MA, et al. Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry. Ann Rheum Dis. 2021;80:930–42.

Article  CAS  PubMed  Google Scholar 

Konig MF, Grzes KM, Robinson PC, Pearce EJ. Sulfasalazine: a risk factor for severe COVID-19? Lancet Rheumatol. 2022;4:e388–9.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Rentsch CT, DeVito NJ, MacKenna B, et al. Effect of pre-exposure use of hydroxychloroquine on COVID-19 mortality: a population-based cohort study in patients with rheumatoid arthritis or systemic lupus erythematosus using the OpenSAFELY platform. Lancet Rheumatol. 2021;3:e19–27.

Article  CAS  PubMed  Google Scholar 

The RECOVERY Collaborative Group. Dexamethasone in hospitalized patients with Covid-19. N Engl J Med. 2021;384:693–704.

Article  Google Scholar 

Braun-Moscovici Y, Kaplan M, Braun M, Markovits D, Giryes S, Toledano K, Tavor Y, Dolnikov K, Balbir-Gurman A. Disease activity and humoral response in patients with inflammatory rheumatic diseases after two doses of the Pfizer mRNA vaccine against SARS-CoV-2. Ann Rheum Dis. 2021;80:1317–21.

Article  CAS  PubMed  Google Scholar 

Haberman RH, Herati R, Simon D, et al. Methotrexate hampers immunogenicity to BNT162b2 mRNA COVID-19 vaccine in immune-mediated inflammatory disease. Ann Rheum Dis. 2021;80:1339–44.

Article  CAS  PubMed  Google Scholar 

Park JK, Lee YJ, Shin K, Ha Y-J, Lee EY, Song YW, Choi Y, Winthrop KL, Lee EB. Impact of temporary methotrexate discontinuation for 2 weeks on immunogenicity of seasonal influenza vaccination in patients with rheumatoid arthritis: a randomised clinical trial. Ann Rheum Dis Annrheum Dis. 2018;77(6):898–904.

CAS  Google Scholar 

Park JK, Lee YJ, Shin K, et al. A multicenter, prospective, randomized, parallel-group trial on the effects of temporary methotrexate discontinuation for one week versus two weeks on seasonal influenza vaccination in patients with rheumatoid arthritis. Arthritis Rheumatol. 2023;75:171–7.

Article  CAS  PubMed  Google Scholar 

Park JK, Lee MA, Lee EY, Song YW, Choi Y, Winthrop KL, Lee EB. Effect of methotrexate discontinuation on efficacy of seasonal influenza vaccination in patients with rheumatoid arthritis: a randomised clinical trial. Ann Rheum Dis. 2017;76:1559–65.

Article  CAS  PubMed  Google Scholar 

Khoury DS, Cromer D, Reynaldi A, Schlub TE, Wheatley AK, Juno JA, Subbarao K, Kent SJ, Triccas JA, Davenport MP. Neutralizing antibody levels are highly predictive of immune protection from symptomatic SARS-CoV-2 infection. Nat Med. 2021;27:1205–11.

Article  CAS  PubMed  Google Scholar 

Feng S, Phillips DJ, White T, et al. Correlates of protection against symptomatic and asymptomatic SARS-CoV-2 infection. Nat Med. 2021;27:2032–40.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Gilbert PB, Montefiori DC, McDermott AB, et al. Immune correlates analysis of the mRNA-1273 COVID-19 vaccine efficacy clinical trial. Science. 2022;375:43–50.

Article  CAS  PubMed  Google Scholar 

Abhishek A, Boyton RJ, Peckham N, et al. Effect of a 2-week interruption in methotrexate treatment versus continued treatment on COVID-19 booster vaccine immunity in adults with inflammatory conditions (VROOM study): a randomised, open label, superiority trial. Lancet Respir Med. 2022;10:840–50. This was a well-designed randomized controlled trial that found suspending methotrexate for 2 weeks at the time of a COVID-19 booster dose resulted in increased vaccine immunogenicity in patients with immune-mediated inflammatory disease patients. However, patients suspending methotrexate experienced a higher rate of RA flares

Article  CAS  PubMed  PubMed Central  Google Scholar 

Araujo CSR, Medeiros-Ribeiro AC, Saad CGS, et al. Two-week methotrexate discontinuation in patients with rheumatoid arthritis vaccinated with inactivated SARS-CoV-2 vaccine: a randomised clinical trial. Ann Rheum Dis. 2022;81:889–97.

Article  CAS  PubMed  Google Scholar 

Skaria TG, Sreeprakash A, Umesh R, et al. Withholding methotrexate after vaccination with ChAdOx1 nCov19 in patients with rheumatoid or psoriatic arthritis in India (MIVAC I and II): results of two, parallel, assessor-masked, randomised controlled trials. Lancet Rheumatol. 2022;4:e755–64.

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