Clinical Outcomes of CoVid-19 in Patients Taking Tumor Necrosis Factor Inhibitors and/or Methotrexate: A Multi-Center Research Network Study

Yousaf, Ahmed; Gayam, Swapna; Feldman, Steve; Zinn, Zachary; Kolodney, Michael

Background Data on the impact of biologics and immunomodulators on CoVid-19 related outcomes remains scarce. Objective To determine whether patients on tumor necrosis factor inhibitor (TNFi) and/or methotrexate are at increased risk of CoVid-19 related outcomes. Methods In this large comparative cohort study, a real-time search and analysis were performed on adult patients diagnosed with CoVid-19 and treated with TNFi and/or methotrexate versus those not treated. Likelihood of hospitalization and mortality were compared between groups with and without propensity score matching for confounding factors. Results 53,511,836 unique patient records were analyzed, of which 32,076 (0.06%) had a CoVid-19-related diagnosis documented starting after January 20, 2020. 214 patients with CoVid-19 were identified with recent TNFi or methotrexate exposure compared to 31,862 patients with CoVid-19 without TNFi or methotrexate exposure. After propensity matching, likelihood of hospitalization and mortality were not significantly different between the treatment and non-treatment group (risk ratio 0.91, 95% confidence interval [CI] 0.68-1.22, p=0.5260; risk ratio 0.87, 95% CI 0.42-1.78, p=0.6958, respectively). Limitations All TNFi may not behave similarly. Conclusion Our study suggests that patients with recent TNFi and/or methotrexate exposure do not have increased hospitalization or mortality compared to CoVid-19 patients without recent TNFi and/or methotrexate exposure.