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, S.K.; Yates, M.; Langan, S.M.; Yiu, Z.Z.N.; Tsakok, T.; Dand, N.; Mason, K.J.; McAteer, H.; Meynell, F.; Coker, B.; Vincent, A.; Urmston, D.; Vesty, A.; Kelly, J.; Lancelot, C.; Moorhead, L.; Bachelez, H.; Bruce, I.N.; Capon, F.; Contreras, C.R.; Cope, A.P.; De La Cruz, C.; Di Meglio, P.; Gisondi, P.; Hyrich, K.; Jullien, D.; Lambert, J.; Marzo‐Ortega, H.; McInnes, I.; Naldi, L.; Norton, S.; Puig, L.; Sengupta, R.; Spuls, P.; Torres, T.; Warren, R.B.; Waweru, H.; Weinman, J.; Griffiths, C.E.M.; Barker, J.N.; Brown, M.A.; Galloway, J.B.; Smith, C.H.; study groups, PsoProtect CORE‐UK
Dr Kayleigh Mason email@example.com
C. De La Cruz
P. Di Meglio
PsoProtect CORE‐UK study groups
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.
|Journal Article Type||Article|
|Acceptance Date||Dec 19, 2020|
|Online Publication Date||Jul 1, 2021|
|Publication Date||Jul 1, 2021|
|Publicly Available Date||May 30, 2023|
|Journal||British Journal of Dermatology|
|Peer Reviewed||Peer Reviewed|
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