ERN ReCONNET points to consider for treating patients living with autoimmune rheumatic diseases with antiviral therapies and anti-SARS-CoV-2 antibody products

Abstract

Patient and public involvement: ePAG were involved in the work as members of the Task Force. Disclaimer: ERN ReCONNET is one of the 24 European Reference Networks (ERNs) approved by the ERN Board of Member States. The ERNs are co-funded by the European Commission. The content of this publication represents the views of the authors only and it is their sole responsibility; it cannot be considered to reflect the views of the European Commission and/or the Consumers, Health, Agriculture and Food Executive Agency (CHAFEA) or any other body of the European Union. The European Commission and the Agency do not accept any responsibility for use that may be made of the information it contains.

Efficacy and Safety of Anti-SARS-CoV-2 Antiviral Agents and Monoclonal Antibodies in Patients with SLE: A Case-Control Study

“…Due to the turbulent pace of the COVID-19 pandemic, limited comparable evidence exists in the literature. Indeed, the number of immunocompromised patients receiving anti-SARS-CoV-2 treatments was quite low in our and other cohorts, especially when considering that such patients were predicted to have a higher prevalence of risk factors fitting the criteria for antivirals and monoclonal antibodies [ 36 ]. However, consistent with this finding, rates of monoclonal antibody and antiviral use have also been lower than expected in the general population.…”

“…However, consistent with this finding, rates of monoclonal antibody and antiviral use have also been lower than expected in the general population. Insufficient preparedness of health systems in terms of logistics, communication and healthcare personnel training, along with the rapid evolution of the pandemic have been claimed as potential explanations for failure to achieve a generalised introduction of these drugs in the common clinical practice, especially in the case of drugs requiring intravenous administration [ 36 , 44 , 45 ]. In accordance with these findings, no randomised controlled trial specifically assessing the role of these pharmacological agents in patients with disorders of the immune system has been published to date.…”

“…In addition, most studies on immunocompromised and rheumatic disease patients only provided outcome descriptions without assessing the COVID-19 course in comparator groups of untreated subjects. The most consistent evidence across published studies has been the overall good safety profile of antivirals and monoclonal antibodies, despite potential complex pharmacological interactions among antivirals and concomitant immunomodulating/immunosuppressant agents [ 36 ]. In line with these findings, we recorded only mild and infrequent adverse events among patients described in our series.…”

“…In parallel with clinical trials, real-life studies confirmed the relatively favourable efficacy and safety profile of these agents in the general population, at least in older subjects [ 33 , 34 , 35 ]. Nonetheless, very limited evidence exists regarding patients with immune-mediated diseases [ 36 , 37 , 38 ]. Therefore, we set up a retrospective multi-centre case-control study focusing on patients with SLE and COVID-19, analysing the impact of targeted anti-SARS-CoV-2 agents both on COVID-19 and the SLE course.…”

COVID-19 prophylaxis, diagnostics, and treatment in patients with rheumatic diseases. The Polish experts panel opinion

“…Rheumatologists play a pivotal role in the assessment of patients with RMDs, and they are responsible for guiding their patients' COVID-19 vaccination. The Eu-ropean Reference Network (ERN) on Rare and Complex Connective Tissue and Musculoskeletal Diseases (Re-CONNET) recommends vaccination as the most effective way to reduce the risk of severe COVID-19, hospitalization, and death [62]. The EULAR and the American College of Rheumatology (ACR) recommend against delaying vaccinations in patients with RMDs; in fact, these diseases constitute indications to vaccinate [63,64].…”