Source
the_stark_reality•
  • Prednisone: Worse (increased) chances of hospitalization
  • DMARD w/ and w/o JAK inhibitors: no change
  • NSAID use: no change
  • anti-TNF: Decreased chances of hospitalization
  • antimalarial: no change

Results A total of 600 cases from 40 countries were included. Nearly half of the cases were hospitalised (277, 46%) and 55 (9%) died. In multivariable-adjusted models, prednisone dose ≥10 mg/day was associated with higher odds of hospitalisation (OR 2.05, 95% CI 1.06 to 3.96). Use of conventional disease-modifying antirheumatic drug (DMARD) alone or in combination with biologics/Janus Kinase inhibitors was not associated with hospitalisation (OR 1.23, 95% CI 0.70 to 2.17 and OR 0.74, 95% CI 0.37 to 1.46, respectively). Non-steroidal anti-inflammatory drug (NSAID) use was not associated with hospitalisation status (OR 0.64, 95% CI 0.39 to 1.06). Tumour necrosis factor inhibitor (anti-TNF) use was associated with a reduced odds of hospitalisation (OR 0.40, 95% CI 0.19 to 0.81), while no association with antimalarial use (OR 0.94, 95% CI 0.57 to 1.57) was observed.

Conclusions We found that glucocorticoid exposure of ≥10 mg/day is associated with a higher odds of hospitalisation and anti-TNF with a decreased odds of hospitalisation in patients with rheumatic disease. Neither exposure to DMARDs nor NSAIDs were associated with increased odds of hospitalisation.

FYI: Digging, "antimalarial" means hydroxychloroquine or chloroquine. 2nd paragraph of Methods on Page 2, and footnotes to Tables 1, 2, and 3.

Looks like the big outcome for them was anti-TNF seems to improve things, and corticosteroids make things worse.

7
EthicalFrames•

I was wondering if anti-TNFs increase the likelihood of severe disease. I imagine it might depend on the degree of disease control, perhaps as measured by the CRP level.

5
WhiterRabbit02•

The paper suggests the opposite

2
Peteostro•

So would being on enbrel improve chances of survival?

1
FourScoreDigital•

I have seen it argued elsewhere it needs a look.. but have not seen it active as being investigated...

1
Peteostro•

Well it’s a tnf inhibitor, which seems like this study is saying improved outcomes. On the other side, probably means you are more susceptible to get infected.

2
TweakedMonkey•

What about Plaquinil? More chance of hospitalization?

1
Silver_Valley•

Plaquenil (hydroxychloroquine) is an antimalerial. The results written above say there was no statistical difference attributable to antimalerials.

1
TweakedMonkey•

I misunderstood, thanks for clarifying.

2
A2Hail•

What category would Methotrexate be in?

1
Silver_Valley•

Caveat: I did not look to see where the paper categorizes it, but methotrexate is generally considered a dmard, which I believe derived from disease modifying antirheumatic drug- it not only treats the disease, it modifies the future course of the disease Yay!

2
FourScoreDigital•

Always a trade off. Your probably correct.

1