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白细胞介素-17 抑制剂治疗银屑病患者的 COVID-19 感染、住院和死亡风险。

Risk of COVID-19 infection, hospitalization, and mortality in patients with psoriasis treated by interleukin-17 inhibitors.

机构信息

Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.

Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.

出版信息

J Dermatolog Treat. 2022 Jun;33(4):2014-2020. doi: 10.1080/09546634.2021.1905766. Epub 2022 Mar 21.

Abstract

BACKGROUND

The risk of the infection and its complications under this drug class remains to be determined.

OBJECTIVE

To evaluate the risk of COVID-19, COVID-19-associated hospitalization, and mortality among patients with psoriasis treated by IL-17I.

METHODS

A population-based cohort study was performed to compare psoriasis patients treated by IL-17I ( = 680) with those treated by methotrexate ( = 2153) and non-systemic/non-immunomodulatory treatments ( = 138,750) regarding the incidence of COVID-19 and its complications.

RESULTS

The use of IL-17I was not associated with an increased risk of COVID-19 infection [adjusted HR for IL-17I vs. methotrexate: 0.91 (95% CI, 0.48-1.72); IL-17I vs. non-systemic/non-immunomodulatory treatments: 0.92 (95% CI, 0.54-1.59)]. IL-17I was associated with comparable risk of COVID-19-associated hospitalization [adjusted HR for IL-17I vs. methotrexate: 0.42 (95% CI, 0.05-3.39); IL-17I vs. non-systemic/non-immunomodulatory treatments: 0.65 (95% CI, 0.09-4.59)] and COVID-19-associated mortality [adjusted HR for IL-17I vs. methotrexate: 7.57 (95% CI, 0.36-157.36); IL-17I vs. non-systemic/non-immunomodulatory treatments: 7.05 (95% CI, 0.96-51.98)]. In a sensitivity analysis, neither secukinumab nor ixekizumab imposed an elevated risk of any of the outcomes of interests.

CONCLUSIONS

IL-17I treatment does not confer an increased risk of COVID-19 infection or its complications in patients with psoriasis. Our findings support the continuation of IL-17I treatment during the pandemic.

摘要

背景

在这类药物下,感染及其并发症的风险仍需确定。

目的

评估白细胞介素 17(IL-17)抑制剂治疗的银屑病患者感染 COVID-19、COVID-19 相关住院和死亡的风险。

方法

进行了一项基于人群的队列研究,比较了接受 IL-17I(680 例)、甲氨蝶呤(2153 例)和非系统/非免疫调节治疗(138750 例)的银屑病患者 COVID-19 及其并发症的发生率。

结果

使用 IL-17I 与 COVID-19 感染风险增加无关(IL-17I 与甲氨蝶呤相比:调整后的 HR,0.91(95%CI,0.48-1.72);IL-17I 与非系统/非免疫调节治疗相比:0.92(95%CI,0.54-1.59))。IL-17I 与 COVID-19 相关住院治疗的风险相当(IL-17I 与甲氨蝶呤相比:调整后的 HR,0.42(95%CI,0.05-3.39);IL-17I 与非系统/非免疫调节治疗相比:0.65(95%CI,0.09-4.59))和 COVID-19 相关死亡率(IL-17I 与甲氨蝶呤相比:调整后的 HR,7.57(95%CI,0.36-157.36);IL-17I 与非系统/非免疫调节治疗相比:7.05(95%CI,0.96-51.98))。在敏感性分析中,司库奇尤单抗和依奇珠单抗均未增加任何感兴趣结局的风险。

结论

IL-17I 治疗不会增加银屑病患者 COVID-19 感染或其并发症的风险。我们的研究结果支持在大流行期间继续使用 IL-17I 治疗。

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