Evidence map›Paper›PMID 33786454›Full record

ArticleThe Lancet. Rheumatology2021

COVID-19 outcomes in patients with inflammatory rheumatic and musculoskeletal diseases treated with rituximab: a cohort study.

Jérôme Avouac, Elodie Drumez, Eric Hachulla, Raphaèle Seror, Sophie Georgin-Lavialle, Soumaya El Mahou, Edouard Pertuiset, Thao Pham, Hubert Marotte, Amélie Servettaz and 15 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet. Rheumatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 149 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
149citing papers in PubMed, 3 pooled it
17.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

149 citing papers in PubMed, 3 syntheses or guidelines pooled it, 290 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Trial
  6. Trial
  7. Trial
  8. Article
  9. CD56Clinical & translational immunology · 2026
    Article
  10. Review
  11. Article
  12. Review
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Observational
  19. Review
  20. Article

89 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors at 17 institutions in 1 country.

Jérôme AvouacUniversité de Paris, Service de Rhumatologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Centre Université de Paris, Paris, France.
Elodie DrumezULR 2694-METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, Université de Lille, CHU Lille, Lille, France.
Eric HachullaUniversité de Lille, INSERM, CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Autoimmunes Systémiques Rares Du Nord et Nord-Ouest de France, U1286-INFINITE: Institute for Translational Research in Inflammation, Le Kremlin-Bicêtre, France.
Raphaèle SerorUniversité Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Service de Rhumatologie, Centre de Référence des Maladies Autoimmunes Systémiques Rares, Hôpital Bicêtre, INSERM UMR 1184, Le Kremlin-Bicêtre, France.
Sophie Georgin-LavialleSorbonne Université, Service de Médecine Interne, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France.
Soumaya El MahouService de Rhumatologie, Centre Hospitalier de Tourcoing, Tourcoing, France.
Edouard PertuisetService de Rhumatologie, Centre Hospitalier René Dubos, Pontoise, France.
Thao PhamService de Rhumatologie, Aix-Marseille Université, Assistance Publique-Hôpitaux de Marseille, Marseille, France.
Hubert MarotteINSERM 1059, Université de Lyon, Saint-Etienne, France.
Amélie ServettazService de Médecine Interne, Maladies Infectieuses et Immunologie Clinique, CHU Reims, Hôpital Robert Debré, Reims, France.
Fanny DomontSorbonne Université, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Service de Médecine Interne et Immunologie Clinique, Paris, France.
Pascal ChazerainService de Rhumatologie et Médecine Interne, Groupe Hospitalier Diaconesses-croix St-Simon, Paris, France.
Mathilde DevauxService de Médecine Interne, CHI Poissy Saint Germain, Poissy, France.
Pascal ClaudepierreEpiDermE, Université Paris Est Créteil, Service de Rhumatologie, Hôpital Henri-Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France.
Vincent LangloisService de Maladies Infectieuses et Médecine Interne, Groupe Hospitalier du Havre, Le Havre, France.
Arsène MekinianSorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Service de Médecine Interne et Inflammation- (DMU i3), Paris, France.
Alexandre Thibault Jacques MariaService de Médecine Interne: Maladies Multi-Organiques, CHU Montpellier, Montpellier, France.
Béatrice BannevilleSorbonne Université, Assistance Publique-Hôpitaux de Paris, Service de Rhumatologie, Hôpital de la Pitié-Salpêtrière, Paris, France.
Bruno FautrelSorbonne Université, Assistance Publique-Hôpitaux de Paris, Service de Rhumatologie, Hôpital de la Pitié-Salpêtrière, Paris, France.
Jacques PouchotHôpital Européen Georges-Pompidou, Médecine Interne, Assistance Publique-Hôpitaux de Paris, Paris, France.
Thierry ThomasService de Rhumatologie, Hôpital Nord, CHU de Saint-Etienne, INSERM U1059, Université de Lyon-Université Jean Monnet, Saint Etienne, France.
René-Marc FlipoService de Rhumatologie, Université Lille, CHU Lille, Lille.
Christophe RichezService de Rhumatologie, Centre de Référence des Maladies Autoimmunes Systémiques Rares de l'Est et du Sud-Ouest de France, CHU de Bordeaux and UMR-CNRS 5164, Université de Bordeaux, Bordeaux, France.
FAI2R/SFR/SNFMI/SOFREMIP/CRI/IMIDIATE consortium and contributors
FAIR/SFR/SNFMI/SOFREMIP/CRI/IMIDIATE consortium and contributors
Sorbonne Université · FRUniversité Paris-Est Créteil · FRCentre National de la Recherche Scientifique · FRUniversité de Lille · FRUniversité Claude Bernard Lyon 1 · FRAssistance Publique – Hôpitaux de Paris · FRCentre Hospitalier Intercommunal de Poissy · FRCentre Hospitalier Universitaire de Montpellier · FRGroupe Hospitalier du Havre · FRInserm · FRAix-Marseille Université · FRCentre Hospitalier Universitaire de Reims · FRUniversité Paris Cité · FRCentre Hospitalier de Tourcoing · FRCentre Hospitalier René-Dubos · FRCentre Hospitalier Universitaire de Besançon · FRGroupe Hospitalier Diaconesses Croix Saint-Simon · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVarious observations have suggested that the course of COVID-19 might be less favourable in patients with inflammatory rheumatic and musculoskeletal diseases receiving rituximab compared with those not receiving rituximab. We aimed to investigate whether treatment with rituximab is associated with severe COVID-19 outcomes in patients with inflammatory rheumatic and musculoskeletal diseases.

methodsIn this cohort study, we analysed data from the French RMD COVID-19 cohort, which included patients aged 18 years or older with inflammatory rheumatic and musculoskeletal diseases and highly suspected or confirmed COVID-19. The primary endpoint was the severity of COVID-19 in patients treated with rituximab (rituximab group) compared with patients who did not receive rituximab (no rituximab group). Severe disease was defined as that requiring admission to an intensive care unit or leading to death. Secondary objectives were to analyse deaths and duration of hospital stay. The inverse probability of treatment weighting propensity score method was used to adjust for potential confounding factors (age, sex, arterial hypertension, diabetes, smoking status, body-mass index, interstitial lung disease, cardiovascular diseases, cancer, corticosteroid use, chronic renal failure, and the underlying disease [rheumatoid arthritis

findingsBetween April 15, 2020, and Nov 20, 2020, data were collected for 1090 patients (mean age 55·2 years [SD 16·4]); 734 (67%) were female and 356 (33%) were male. Of the 1090 patients, 137 (13%) developed severe COVID-19 and 89 (8%) died. After adjusting for potential confounding factors, severe disease was observed more frequently (effect size 3·26, 95% CI 1·66-6·40, p=0·0006) and the duration of hospital stay was markedly longer (0·62, 0·46-0·85, p=0·0024) in the 63 patients in the rituximab group than in the 1027 patients in the no rituximab group. 13 (21%) of 63 patients in the rituximab group died compared with 76 (7%) of 1027 patients in the no rituximab group, but the adjusted risk of death was not significantly increased in the rituximab group (effect size 1·32, 95% CI 0·55-3·19, p=0·53).

interpretationRituximab therapy is associated with more severe COVID-19. Rituximab will have to be prescribed with particular caution in patients with inflammatory rheumatic and musculoskeletal diseases.

fundingNone.

Identifiers

PMID33786454
PMCPMC7993930
OpenAlexW3144879873

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.