Effects of Biologic Therapies for Cutaneous Inflammatory Diseases in HIV-Infected Individuals: Reliable or Not?

Abstract Background and Aims As no population-based study has investigated the susceptibility and disease course of COVID-19 among patients with inflammatory bowel diseases [IBD], we aimed to investigate this topic in a population-based setting. Methods Two cohorts were investigated. First, a nationwide cohort of all IBD patients diagnosed with COVID-19 was prospectively followed to investigate the disease courses of both diseases. Second, within a population-based cohort of 2.6 million Danish citizens, we identified all individuals tested for SARS-CoV-2 to determine the occurrence of COVID-19 among patients with and without IBD and other immune-mediated inflammatory diseases [IMIDs]. Results Between January 28, 2020 and June 2, 2020, a total of 76 IBD patients with COVID-19 were identified in the national cohort and prospectively followed for 35 days (interquartile range [IQR]: 25–51). A large proportion [n = 19: 25%] required a COVID-19-related hospitalisation for 7 days [IQR: 2–8.5] which was associated with being 65 years or older (odds ratio [OR] = 23].80, 95% confidence interval [CI] 6.32–89.63, p <0.01) and presence of any non-IMID comorbidity [OR = 8.12, 95% CI 2.55–25.87, p <0.01], but not use of immunomodulators [p = 0.52] or biologic therapies [p = 0.14]. In the population-based study, 8476 of 231 601 [3.7%] residents tested positive for SARS-CoV-2; however, the occurrence was significantly lower among patients with IBD [62 of the 2486 patients = 2.5%, p <0.01] and other IMIDs [531 of 16 492 patients = 3.2%, p <0.01] as compared with patients without IMIDs. Conclusions Patients with IMIDs, including IBD, had a significantly lower susceptibility to COVID-19 than patients without IMIDs, and neither immunosuppressive therapies nor IBD activity were associated with the disease course of COVID-19.

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Comparison of Sinonasal Histopathological Changes in Biological Treatment of Eosinophilic Chronic Rhinosinusitis

American Journal of Rhinology and Allergy ◽

10.1177/19458924211021031 ◽

2021 ◽

pp. 194589242110210

Author(s):

Jacqueline Ho ◽

Raquel Alvarado ◽

Janet Rimmer ◽

William A. Sewell ◽

Sophie Walter ◽

...

Keyword(s):

Chronic Rhinosinusitis ◽

Inflammatory Diseases ◽

Histopathological Examination ◽

Tissue Level ◽

Tissue Response ◽

Sinus Surgery ◽

Biologic Therapies ◽

Eosinophilic Asthma ◽

Cross Sectional ◽

Eosinophilic Chronic Rhinosinusitis

Background Biologic therapies such as mepolizumab and benralizumab are currently utilised in the treatment of eosinophilic asthma, and are emerging in the management of eosinophilic chronic rhinosinusitis (eCRS). These biologics inhibit the interaction of IL-5 with its receptor, thus impairing cytokine signalling and eosinophil inflammation. Mepolizumab does so by targeting IL-5, whereas benralizumab targets the α chain of the IL-5 receptor. This study compares the sinonasal tissue response to anti-IL-5 biologic therapies in patients with eCRS. Methods A cross-sectional study of adult eCRS patients who had completed at least 2 cycles of biologic therapy and underwent endoscopic sinus surgery as part of their management were included. Sinonasal mucosal tissue biopsies were obtained intraoperatively and assessed with structured histopathological examination. Comparisons of tissue histopathology outcomes following treatment with mepolizumab or benralizumab were performed. Results 18 patients (age 49.6 ± 14.2 years, 47% female, 100% co-morbid asthma) were included in this study, comprising 10 patients managed with mepolizumab and 8 patients managed with benralizumab. Even after mepolizumab, the tissue had predominantly eosinophilic inflammation compared to benralizumab (90% v 0%, p < 0.01), which demonstrated a greater lymphoplasmacytic inflammation (10% v 75%, χ2(2) = 14.53, p < 0.01). Compared with benralizumab, mepolizumab had increased tissue eosinophil count (100% v 37.5% >10 eosinophils/HPF, τb = −8.47, p < 0.001) and more severe subepithelial oedema (80% v 37.5% severe, τb = −2.37, p = 0.02). Conclusion Tissue histopathologic outcomes reflect the differing mechanism of action of mepolizumab and benralizumab in eCRS. Further analysis at the tissue level will provide further information to guide application of mAbs in type 2 inflammatory diseases.

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Beyond Tumor Necrosis Factor Inhibition: The Expanding Pipeline of Biologic Therapies for Inflammatory Diseases and Their Associated Infectious Sequelae

Clinical Infectious Diseases ◽

10.1093/cid/ciu104 ◽

2014 ◽

Vol 58 (11) ◽

pp. 1587-1598 ◽

Cited By ~ 32

Author(s):

S. A. Novosad ◽

K. L. Winthrop

Keyword(s):

Tumor Necrosis Factor ◽

Tumor Necrosis ◽

Inflammatory Diseases ◽

Biologic Therapies ◽

Tumor Necrosis Factor Inhibition ◽

Necrosis Factor

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Adverse Events Following SARS-CoV-2 mRNA Vaccination Among Patients with Inflammatory Bowel Disease

10.1101/2021.03.30.21254607 ◽

2021 ◽

Author(s):

Gregory J. Botwin ◽

Dalin Li ◽

Jane Figueiredo ◽

Susan Cheng ◽

Jonathan Braun ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

General Population ◽

Adverse Events ◽

Bowel Disease ◽

Biologic Therapy ◽

Inflammatory Diseases ◽

Biologic Therapies ◽

Vaccine Trials ◽

Immune Mediated ◽

Inflammatory Bowel

AbstractPatients with immune-mediated inflammatory diseases (IMID) such as inflammatory bowel disease (IBD) on immunosuppressive and biologic therapies were largely excluded from SARS-CoV-2 mRNA vaccine trials. We thus evaluated post-mRNA vaccination adverse events (AE) in 246 vaccinated adults with IBD participating in a longitudinal vaccine registry. In general, AE frequency was similar to that reported in the general population. As in the general population, AE were more common among younger patients, and those with prior COVID-19. We additionally found that AE were less common in individuals receiving biologic therapy. Those with IBD and other IMID on these commonly prescribed therapies can be reassured that the AE risk is likely not increased, and may be reduced, while on biologics.

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