Correspondence on "Associations of baseline use of biologic or targeted synthetic DMARDs with COVID-19 severity in rheumatoid arthritis: results from the COVID-19 global rheumatology alliance physician registry"

Sparks et al1 are to be congratulated on an important and timely study. They found that the use of JAKi was associated with worse outcome of COVID-19 infection, and they interpret this as a harmful effect of the treatment in that particular setting. But this question deserves further consideration. Assuming that the observation is correct, what could the mechanism be? As the authors correctly point out, some JAKi’s did show benefits for patients with severe COVID-19 infection.2 3 We, therefore, propose an alternative explanation of the observed data. Some guidance documents,4 5 and certainly medical practice traditions, frequently have patients discontinue immunomodulatory treatments when a potentially severe infection is diagnosed, and it seems safe to assume that the vast majority of patients in the study did, in fact, stop their treatment when they became aware of the infection. While...
Source: Annals of the Rheumatic Diseases - Category: Rheumatology Authors: Tags: Open access, ARD, COVID-19 Correspondence Source Type: research