Various treatments for inflammatory bowel disease (IBD), including biologics, do not increase the risk of COVID-19-related hospitalizations, according to new research.

A team, led by Fatema Alrashed, Department of Pharmacy Practice, Kuwait University, assessed the link between the risk of COVID-19-related hospitalization and various treatments for IBD, including biologics and small molecule compounds.

Treatments

Biologics and small molecule compound drugs often used to treat IBD have been of concern to patients in recent years due to the risk of contracting COVID-19. Additionally, since the onset of the COVID-19 pandemic, there has been concern that immunocompromised individuals are at increased risk for serious outcomes.

In the systematic review and meta-analysis, researchers identified studies reporting COVID-19-related hospitalization for patients with IBD receiving biologic therapies or tofacitinib between December 2019 and September 2021. Together they included 18 studies in the final analysis of the initial 811 studies identified. The studies were based in the United States (n = 6), Italy (n = 5), the United Kingdom (n = 3), France, Spain and Denmark.

The studies

Included are all relevant randomized controlled trials, observational studies, and letters to the editor, as well as data from the SECURE-IBD ​​database. Investigators only used data from adult patients with IBD and confirmed SARS-CoV-2 infections.

They also searched for studies with reported hospitalization data in IBD patients infected with SARS-CoV-2, who received biologic therapies including adalimumab, infliximab, vedolizumab and ustekinumab. or small molecule janus kinase inhibitors.

The researchers searched for primary outcomes of the risk of COVID-19-related hospitalization in patients taking biologic therapy or small-molecule JAK inhibitors.

The risk

The relative risk of hospitalization was significantly lower for patients with IBD and COVID-19 who were treated with biologics (RR, 0.47; 95% CI, 0.42-0.52; P

The relative risk was also lower in patients receiving tumor necrosis factors (TNF) compared to patients who did not (RR, 0.48; 95% CI, 0.41-0.55; P

Similarly, patients treated with ustekinumab also had a lower relative risk (RR, 0.55; 95% CI, 0.43-0.72; P

The investigators also learned that a combination therapy including an anti-TNF and an immunomodulator did not reduce the overall risk of COVID-19-related hospitalization (RR, 0.98; 95% CI, 0.82-1, 18; P = 0.84).

In contrast, vedolizumab (RR, 1.13; 95% CI, 0.75-1.73; P = 0.56) and tofacitinib (RR, 0.81; 95% CI, 0.49-1.33; P = 0.40) were not associated with a lower risk of COVID-19-related hospitalization.

“Regarding COVID-19-related hospitalizations in IBD, anti-TNFs and ustekinumab were associated with a decreased risk of hospitalization. Additionally, vedolizumab and tofacitinib were not associated with hospitalization related to COVID-19,” the authors wrote.

The study, “Impact of Biologics and Small Molecules for Inflammatory Bowel Disease on COVID-19 Hospitalization and Mortality: A Systematic Review and Meta-Analysis,” was published online in Open JGH.