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*
Mahil, Satveer K.
Yates, Mark (King's College London)
Langan, Sinead M. (London School of Hygiene and Tropical Medicine)
Yiu, Zenas Z.N.
Tsakok, Teresa
Dand, Nick
Mason, Kayleigh J.
McAteer, Helen
Meynell, Freya
Coker, Bolaji
Vincent, A. (Guy's and St Thomas' NHS Foundation Trust)
Urmston, Dominic
Vesty, Amber
Kelly, J. (The University of Manchester)
Lancelot, Camille (France Veterinary International)
Moorhead, Lucy (Guy's and St Thomas' NHS Foundation Trust)
Bachelez, Hervé (Université Paris Cité)
Bruce, I.N. (The University of Manchester)
Capon, Francesca (King's College London)
Contreras, Claudia Romina (Universidad Nacional de Asunción)
Cope, Andrew P. (Kingston College United Kingdom)
De La Cruz, C. (University of Santiago, Chile)
Di Meglio, Paola (Newcastle University)
Gisondi, Paolo (University of Verona)
Hyrich, Kimme (The University of Manchester)
Jullien, Denis (Hospices Civils de Lyon (Centre Hospitalier Universitaire de Lyon))
Lambert, Julien
Marzo-Ortega, H. (Leeds Teaching Hospitals NHS Trust)
McInnes, Iain B. (University of Glasgow)
Naldi, L. (San Bortolo Hospital)
Norton, Sam (King's College London)
Puig Sanz, Lluís (Institut d'Investigació Biomèdica Sant Pau)
Sengupta, Raj (Royal National Hospital For Rheumatic Diseases NHS Foundation Trust)
Spuls, Phyllis (University of Amsterdam)
Torres, Tiago (Centro Hospitalar e Universitário do Porto)
Warren, Richard B. (The University of Manchester)
Waweru, Hoseah (Upper Hill Medical Centre)
Weinman, John (King's College London)
Griffiths, Chris E.M. (The University of Manchester)
Barker, Jonathan (The Kings College)
Brown, Matthew A. (Guy's and St Thomas' NHS Foundation Trust)
Galloway, James B.
Smith, Catherine (King's College London)

Date:	2021
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.
Note:	Altres ajuts: Department of Health via the National Institute for Health Research (NIHR); St Thomas' NHS Foundation Trust; King's College London; NIHR Manchester Biomedical Research Centre; Psoriasis Association. Wellcome Senior Research Fellowship in Clinical Science (205039/Z/16/Z); Health Data Research UK (grant no. LOND1); Health Data Research UK (grant no. MR/S003126/1); UK MRC, Engineering and Physical Sciences Research Council; Economic and Social Research Council; Department of Health and Social Care (England); Chief Scientist Office of the Scottish Government Health; Social Care Directorates; Health and Social Care Research and Development Division (Welsh Government); Public Health Agency (Northern Ireland); British Heart Foundation; Wellcome Trust; NIHR Academic Clinical Lectureship through the University of Manchester; NIHR Emeritus Senior Investigator (MR/101 1808/1); NIHR Manchester Biomedical Research Centre.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	COVID-19 ; Cross-Sectional Studies ; Humans ; Joint Diseases ; Male ; Pandemics ; SARS-CoV-2
Published in:	British journal of dermatology, Vol. 185 Núm. 1 (july 2021) , p. 80-90, ISSN 1365-2133

DOI: 10.1111/bjd.19755
PMID: 33368145

11 p, 652.6 KB

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Articles > Research articles
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