Clinical course of COVID-19 in a cohort of 342 familial Mediterranean fever patients with a long-term treatment by colchicine in a French endemic area

Bourguiba, R.; Delplanque, Marion; Vinit, Caroline; Ackermann, Félix; Savey, Léa; Grateau, Gilles; Hentgen, Véronique; Georgin-Lavialle, S.

doi:10.1136/annrheumdis-2020-218707

Cited by 31 publications

(40 citation statements)

References 5 publications

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“…According to this theoretical knowledge, colchicine may be helpful in the management of COVID-19. Low incidence rates of COVID-19 and related severe outcomes found Bourguiba’s [ 21 ], and our study might be explained by the fact that all FMF patients in these studies were on colchicine treatment. Similarly, most patients with monogenic autoinflammatory disease in Haslak’s [ 22 ] study were on colchicine treatment.…”

Section: Discussionmentioning

confidence: 53%

“…Therefore, the frequency and severity of SARS-CoV-2 infection in FMF are intriguing. Bourguiba et al found similar incidence rates of COVID-19 in FMF patients (8%) and the general population (11%) in a French endemic area [ 21 ]. They also reported that FMF patients with severe SARS-CoV-2 infection have known risk factors like increased age, obesity, and hypertension.…”

Section: Discussionmentioning

confidence: 99%

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The impact of COVID-19 on familial Mediterranean fever: a nationwide study

et al. 2021

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The study aimed to evaluate the impact of the coronavirus disease 2019 in patients with familial Mediterranean fever (FMF) and to assess the relationships between FMF characteristics and severe COVID-19 outcomes such as hospitalization. The study was planned within a national network of 21 different centers. Demographics, FMF-related clinical and genetic characteristics, and COVID-19 outcomes were obtained. A total of 822 patients with FMF (mean age of 36 years) were included in the study. Fifty-nine of them (7%) had a COVID-19 diagnosis confirmed by real-time PCR test or chest CT findings. Most FMF patients with COVID-19 (58) had mild and moderate disease activity. All patients were on colchicine treatment. However, 8 of them (13.6%) were not compliant with colchicine use and 9 of them (15.3%) were colchicine resistant. Twelve FMF patients with COVID-19 were hospitalized. There were 4 patients requiring oxygen support. COVID-19 related complications were observed in 2 patients (1 thromboembolism, 1 acute respiratory distress syndrome). Hospitalized COVID-19 patients with FMF were older than non-hospitalized patients (median ages: 51 and 31 years, respectively; p: 0.002). Other FMF-related characteristics were similar between the groups. FMF-related characteristics were not found to be associated with poor outcomes in COVID-19. Thus, FMF may not be a risk factor for poor COVID-19 outcomes. Keywords COVID-19 • Familial Mediterranean fever • Rheumatic diseases • Colchicine • Hospitalization • Poor outcomes Abbreviations CT Computerized tomography COVID-19 Coronavirus disease 2019 DMARD Disease modifying antirheumatic drug FMF Familial Mediterranean fever IL-1 Interleukin-1 NLRP3 NOD-, LRR-and pyrin domain-containing protein 3 RCT Randomized controlled trial RT-PCR Reverse transcription-polymerase chain reaction SARS-CoV-2 Severe acute respiratory syndrome-coronavirus-2 TNF Tumor necrosis factor Rheumatology INTERNATIONAL

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

The impact of COVID-19 on familial Mediterranean fever: a nationwide study

et al. 2021

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“…Other studies have shown that the chronic use of colchicine was not associated with a higher risk of severe COVID-19: in a cohort of patients with familial Mediterranean fever, 23 a similar proportion of severe SARS-CoV-2 infection compared with the general population was reported. Furthermore, a group of five patients with iatrogenic allogenosis 24 seemed to present with a milder COVID-19 course compared with their close contacts who also developed the disease.…”

Section: Discussionmentioning

confidence: 71%

Influence of colchicine prescription in COVID-19-related hospital admissions: a survival analysis

Madrid

Pérez

Colomer

et al. 2021

Therapeutic Advances in Musculoskeletal

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Aims: To analyze the association between colchicine prescription and COVID-19-related hospital admissions in patients with rheumatic and musculoskeletal diseases (RMDs). Methods: Patients attending a rheumatology outpatient clinic from a tertiary care center in Madrid, Spain, from 1 September 2019 to 29 February 2020 were included. Patients were assigned as exposed or unexposed based on whether they were prescribed with colchicine in their last visit to the clinic during the 6 months before the start of the observation period. Treatment changes during the observation period were also considered. The primary outcome was COVID-19-related hospital admissions between 1 March and 20 May 2020. Secondary outcome included COVID-19-related mortality. Several weighting techniques for data balancing, based and non-based on the propensity score, followed by Cox regressions were performed to estimate the association of colchicine prescription on both outcomes. Discussion: The number of patients entered in the study was 9379, with 406 and 9002 exposed and unexposed follow-up periods, respectively. Generalized Boosted Models (GBMs) and Empirical Balancing Calibration Weighting (EBCW) methods showed the best balance for COVID-19-related hospital admissions. Colchicine prescription did not show a statistically significant association after covariable balancing ( p-value = 0.195 and 0.059 for GBM and EBCW, respectively). Regarding mortality, the low number of events prevented a success variable balancing and analysis. Conclusion: Colchicine prescription does not play a significant protective or risk role in RMD patients regarding COVID-19-related hospital admissions. Our observations could support the maintenance of colchicine prescription in those patients already being treated, as it is not associated with a worse prognosis. Plain language title: Colchicine influence in COVID-19-related hospital admissions

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“…The 8.0% prevalence of confirmed COVID-19 infection in our series of patients with SAID on biologic therapy is broadly in line with that reported for the general UK adult population. Compared with the reported Parisian experience of familial Mediterranean fever, our patients have had relatively mild disease, with no deaths or requirement for respiratory support [ 9 ]. All patients with COVID-19 managed in the outpatient setting continued their biologics without adverse events, consistent with a previous smaller published series of patients on anakinra [ 10 ].…”

Section: Discussionmentioning

confidence: 86%

COVID-19 and autoinflammatory diseases: prevalence and outcomes of infection and early experience of vaccination in patients on biologics

Peet

Papadopoulou

Sombrito

et al. 2021

Rheumatology Advances in Practice

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Objectives The systemic autoinflammatory diseases are rare conditions, to date data on COVID-19 infection and vaccination safety are scarce. Agents targeting innate immune pathways have transformed management of affected patients, and their outcomes are of wider interest given the role of inflammation in both viral clearance and severe COVID-19 disease. We surveyed patients with systemic autoinflammatory disease on biologic therapy to determine the prevalence and outcomes of COVID-19 infection and to gather early safety data on vaccination. Methods Electronic medical records of 248 patients with systemic autoinflammatory disease on biologic therapy at a national centre were reviewed. Patients were then surveyed in clinic or using a web-based survey. Results In the cohort of 248 patients, no deaths were recorded. 175 survey responses were received. Among the respondents, 27 reported suspected COVID-19 infection, of which 14 were confirmed by testing (8.0%). Two patients required admission due to dehydration. No patient required respiratory support or intensive care. 138 doses of COVID-19 vaccine had been administered to 130 patients. Side effects were reported following 71/138 (51.4%) administrations and were consistent with a flare of the underlying disease in 26/138 (18.8%) instances. No serious adverse events or hospital admissions were reported following vaccination. Conclusions These data, including the largest published series of patients on anti-Interleukin-1/6 biologics to receive any adenoviral vector or mRNA vaccine, show no serious early concerns regarding vaccination and will provide an urgently needed resource to inform decision making of these patients and their clinicians.

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Clinical course of COVID-19 in a cohort of 342 familial Mediterranean fever patients with a long-term treatment by colchicine in a French endemic area

Cited by 31 publications

References 5 publications

The impact of COVID-19 on familial Mediterranean fever: a nationwide study

The impact of COVID-19 on familial Mediterranean fever: a nationwide study

Influence of colchicine prescription in COVID-19-related hospital admissions: a survival analysis

COVID-19 and autoinflammatory diseases: prevalence and outcomes of infection and early experience of vaccination in patients on biologics

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