Nonsteroidal Antiinflammatory Drugs and Susceptibility to COVID‐19

Arthritis and Rheumatology - Tập 73 Số 5 - Trang 731-739 - 2021
Joht Singh Chandan1, Dawit T. Zemedikun2, Rasiah Thayakaran2, Nathan Byne3, Samir Dhalla3, Dionisio Acosta3, Krishna Gokhale2, Tom Thomas4, Christopher Sainsbury2, Anuradhaa Subramanian2, Jennifer Cooper2, Astha Anand2, Kelvin Okoth2, Jingya Wang2, Nicola J. Adderley2, Thomas Taverner2, Alastair K. Denniston5, Janet M. Lord6, G. Neil Thomas2, Christopher D. Buckley7, Karim Raza8, Neeraj Bhala9, Krishnarajah Nirantharakumar10, Shamil Haroon2
1Institute of Applied Health Research, University of Birmingham, Birmingham, UK, and Warwick Medical School, University of Warwick, Coventry, UK
2Institute of Applied Health Research, University of Birmingham, Birmingham, UK
3Cegedim Rx, London, UK
4Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
5Institute of Inflammation and Ageing, University of Birmingham, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
6Institute of Inflammation and Ageing, University of Birmingham, MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK
7Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK, and Institute of Inflammation and Ageing, MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK
8Institute of Inflammation and Ageing, MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, Sandwell and West Birmingham NHS Hospitals Trust, Birmingham, UK
9Institute of Applied Health Research, University of Birmingham, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
10Institute of Applied Health Research, University of Birmingham, Health Data Research UK Midlands, Birmingham, UK

Tóm tắt

ObjectiveTo identify whether active use of nonsteroidal antiinflammatory drugs (NSAIDs) increases susceptibility to developing suspected or confirmed coronavirus disease 2019 (COVID‐19) compared to the use of other common analgesics.MethodsWe performed a propensity score–matched cohort study with active comparators, using a large UK primary care data set. The cohort consisted of adult patients age ≥18 years with osteoarthritis (OA) who were followed up from January 30 to July 31, 2020. Patients prescribed an NSAID (excluding topical preparations) were compared to those prescribed either co‐codamol (paracetamol and codeine) or co‐dydramol (paracetamol and dihydrocodeine). A total of 13,202 patients prescribed NSAIDs were identified, compared to 12,457 patients prescribed the comparator drugs. The primary outcome measure was the documentation of suspected or confirmed COVID‐19, and the secondary outcome measure was all‐cause mortality.ResultsDuring follow‐up, the incidence rates of suspected/confirmed COVID‐19 were 15.4 and 19.9 per 1,000 person‐years in the NSAID‐exposed group and comparator group, respectively. Adjusted hazard ratios for suspected or confirmed COVID‐19 among the unmatched and propensity score–matched OA cohorts, using data from clinical consultations in primary care settings, were 0.82 (95% confidence interval [95% CI] 0.62–1.10) and 0.79 (95% CI 0.57–1.11), respectively, and adjusted hazard ratios for the risk of all‐cause mortality were 0.97 (95% CI 0.75–1.27) and 0.85 (95% CI 0.61–1.20), respectively. There was no effect modification by age or sex.ConclusionNo increase in the risk of suspected or confirmed COVID‐19 or mortality was observed among patients with OA in a primary care setting who were prescribed NSAIDs as compared to those who received comparator drugs. These results are reassuring and suggest that in the absence of acute illness, NSAIDs can be safely prescribed during the ongoing pandemic.

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Tài liệu tham khảo

World Health Organization.Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019‐nCoV). January2020. URL:https://www.who.int/news‐room/detail/30‐01‐2020‐statement‐on‐the‐second‐meeting‐of‐the‐international‐health‐regulations‐(2005)‐emergency‐committee‐regarding‐the‐outbreak‐of‐novel‐coronavirus‐(2019‐ncov).

John Hopkins University.COVID‐19 Cashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). URL:https://coronavirus.jhu.edu/map.html.

10.1164/rccm.201802-0229LE

10.1016/j.jpeds.2016.05.025

10.3390/jcm8060786

10.1136/bmj.m1086

10.1136/bmj.m1185

10.1038/s41586-020-2012-7

10.1016/j.cell.2020.02.052

10.1038/s41591-020-0868-6

10.1016/S2213-2600(20)30116-8

10.1159/000375362

COVIDSurg Collaborative, 2020, Elective surgery cancellations due to the COVID‐19 pandemic: global predictive modelling to inform surgical recovery plans, Br J Surg, 107, 1440

NHS England.Acute use of non‐steroidal anti‐inflammatory drugs (NSAIDs) in people with or at risk of COVID‐19. April2020. URL:https://www.england.nhs.uk/coronavirus/publication/acute‐use‐of‐non‐steroidal‐anti‐inflammatory‐drugs/.

World Health Organization.The use of non‐steroidal anti‐inflammatory drugs (NSAIDs) in patients with COVID‐19. April2020. URL:https://www.who.int/publications/i/item/the‐use‐of‐non‐steroidal‐anti‐inflammatory‐drugs‐(nsaids)‐in‐patients‐with‐covid‐19.

Jeong HE, 2020, Association between NSAIDs use and adverse clinical outcomes among adults hospitalised with COVID‐19 in South Korea: a nationwide study, Clin Infect Dis

10.1371/journal.pmed.1003308

King’s College London sponsor.LIBERATE Trial in COVID‐19 (LIBERATE). ClinicalTrials.gov identifier: NCT04334629;2020.

Gokhale KM, 2020, Data extraction for epidemiological research (DExtER): a novel tool for automated clinical epidemiology studies, Eur J Epidemiol

THIN: The Health Improvement Network. URL:https://www.the‐health‐improvement‐network.com/en/.

Blak BT, 2011, Generalisability of The Health Improvement Network (THIN) database: demographics, chronic disease prevalence and mortality rates, Inform Prim Care, 19, 251

10.1001/jama.2019.1347

Dubreuil M, 2018, Risk of myocardial infarction with use of selected non‐steroidal anti‐inflammatory drugs in patients with spondyloarthritis and osteoarthritis, Ann Rheum Dis, 77, 1137

10.1016/j.joca.2019.05.020

10.1016/j.joca.2019.10.001

10.1111/dom.14203

10.1186/s12879-021-05951-w

10.1046/j.1365-2532.1994.1130177.x

World Health Organization.Anatomical Therapeutic Chemical (ATC) classification. URL:https://www.who.int/toolkits/atc‐ddd‐toolkit/atc‐classification.

National Health Service Business Services Authority.Dictionary of medicines and devices (dm+d). URL:https://www.nhsbsa.nhs.uk/pharmacies‐gp‐practices‐and‐appliance‐contractors/dictionary‐medicines‐and‐devices‐dmd.

10.1002/pds.1688

OpenPrescribing.10.1.1: Non‐steroidal anti‐inflammatory drugs. URL:https://openprescribing.net/bnf/100101/.

10.1001/jamainternmed.2018.6101

10.1038/s41586-020-2521-4

10.1136/openhrt-2016-000550

10.1016/S0140-6736(13)60900-9

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Arthritis and Rheumatology

Tập 73 Số 5

731-739

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