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  1. Article ; Online: Prognostic factors of Pasteurella infections: a single-center retrospective cohort study over a 14-year period (2005-2018).

    Dernoncourt, Amandine / Lacroix, Mathilde / Duhaut, Pierre / Salle, Valéry / Schmidt, Jean / Batteux, Benjamin / Hamdad, Farida

    International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

    2022  Volume 116, Page(s) 197–203

    Abstract: Background: Pasteurella spp. can lead to fatal infections in humans.: Objective: To assess prognostic factors of invasive pasteurellosis.: Methods: We conducted a single retrospective cohort study of local versus invasive Pasteurella infections ... ...

    Abstract Background: Pasteurella spp. can lead to fatal infections in humans.
    Objective: To assess prognostic factors of invasive pasteurellosis.
    Methods: We conducted a single retrospective cohort study of local versus invasive Pasteurella infections from January 1, 2005, to December 31, 2018, in the Amiens-Picardie University Hospital, France.
    Results: Forty-five (20.9%) invasive pasteurellosis and 22 (10.2%) complicated local infections were reported among a total of 215 Pasteurella infections. The mortality rate among invasive infections was 22.2% (10/ 45) whereas no death was recorded in local infections group. Non-drug-induced prothrombin time test <70% of standard and platelet counts <100,000/mm
    Conclusion: Invasive pasteurellosis appears as a serious disease in vulnerable patients, particularly if bacteremia and/or coagulopathies occur.
    MeSH term(s) Bacteremia/complications ; Bacteremia/diagnosis ; Bacteremia/epidemiology ; Humans ; Pasteurella ; Pasteurella Infections/complications ; Pasteurella Infections/diagnosis ; Pasteurella Infections/epidemiology ; Prognosis ; Retrospective Studies
    Language English
    Publishing date 2022-01-19
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 1331197-9
    ISSN 1878-3511 ; 1201-9712
    ISSN (online) 1878-3511
    ISSN 1201-9712
    DOI 10.1016/j.ijid.2022.01.028
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Neurological burden and outcomes of excessive β-lactam serum concentrations of critically ill septic patients: a prospective cohort study.

    Zerbib, Yoann / Gaulin, Clement / Bodeau, Sandra / Batteux, Benjamin / Lemaire-Hurtel, Anne-Sophie / Maizel, Julien / Kontar, Loay / Bennis, Youssef

    The Journal of antimicrobial chemotherapy

    2023  Volume 78, Issue 11, Page(s) 2691–2695

    Abstract: Background: Therapeutic drug monitoring (TDM) contributes to optimizing exposure to β-lactam antibiotics. However, how excessive exposure to β-lactams can increase the burden of care of critically ill patients is unclear.: Patients and methods: In a ... ...

    Abstract Background: Therapeutic drug monitoring (TDM) contributes to optimizing exposure to β-lactam antibiotics. However, how excessive exposure to β-lactams can increase the burden of care of critically ill patients is unclear.
    Patients and methods: In a prospective cohort study, we examined whether excessive β-lactam serum concentrations contribute to neurological deterioration and the associated complications of adult septic patients without recent history of neurological disease treated with β-lactams in a medical ICU. Excessive β-lactam concentrations were defined as serum concentrations that exceeded the upper limit of the therapeutic range recommended by the French Societies of Pharmacology and Therapeutics (SFPT) and Anesthesia and Intensive Care Medicine (SFAR). Neurological deterioration was defined as an increase in the neurological Sequential Organ Failure Assessment score (nSOFA) of ≥1 between the day of starting treatment at admission and the day of TDM performed 2 days after treatment initiation.
    Results: We included 119 patients [median age: 65 years; males: 78 (65.5%)] admitted for acute respiratory distress [59 (49.6%)] or septic shock [25 (21%)]. In adjusted logistic regression analysis, an excessive β-lactam serum concentration was associated with neurological deterioration [OR (95% CI): 10.38 (3.23-33.35), P < 0.0001]. Furthermore, in adjusted linear regression analysis, an excessive β-lactam serum concentration was associated with longer time to discharge alive (β=0.346, P = 0.0007) and, among mechanically ventilated patients discharged alive, with longer time to extubation following the withdrawal of sedation (β=0.248, P = 0.0030).
    Conclusions: These results suggest that excessive exposure to β-lactams could complicate the management of septic patients in the ICU and confirm the clinical relevance of the upper concentration limits recommended for dose reduction.
    MeSH term(s) Male ; Adult ; Humans ; Aged ; beta-Lactams ; Anti-Bacterial Agents/pharmacology ; Prospective Studies ; Critical Illness/therapy ; Shock, Septic/drug therapy
    Chemical Substances beta-Lactams ; Anti-Bacterial Agents
    Language English
    Publishing date 2023-09-11
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 191709-2
    ISSN 1460-2091 ; 0305-7453
    ISSN (online) 1460-2091
    ISSN 0305-7453
    DOI 10.1093/jac/dkad284
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Medication-overuse headache: A pharmacovigilance study in France.

    Al Balkhi, Mohamad Houssam / Moragny, Julien / Laville, Solène M / Liabeuf, Sophie / Pecquet, Pauline-Eva / Batteux, Benjamin / Le Souder, Cosette / Bellet, Florelle / Gras, Valérie / Masmoudi, Kamel

    Therapie

    2024  

    Abstract: Background: Overusing medication for primary headaches or other medical conditions can lead to dependency and medication-overuse headache (MOH) as an adverse drug reaction (ADR).: Objectives: To analyse reports of ADRs associated with MOH recorded in ...

    Abstract Background: Overusing medication for primary headaches or other medical conditions can lead to dependency and medication-overuse headache (MOH) as an adverse drug reaction (ADR).
    Objectives: To analyse reports of ADRs associated with MOH recorded in the French national pharmacovigilance database (FPVD).
    Methods: This retrospective study selected all MOH cases reported in the FPVD from January 2000 to June 2023. A search of the High-Level Group Term "headache" was performed for drugs classified under ATC codes for the musculoskeletal and nervous systems. Specific keywords were searched in report narratives to further reduce their number. Voluntary intoxication reports were excluded. Only MOH cases according to the International Classification of Headache Disorders or with a medical diagnosis of MOH were considered.
    Results: Among the 2674 reports associated with the HLGT "headache", for 649 ATC drug codes, only 234 reports correspond to MOH, primarily notified by physicians. The median age was 45 years (IQR: 32-56), with 74.4% females and approximately 61.0% having pre-existing primary headaches. In all, 53.4% of the reports were classified as serious. Among patients, 84.2% had an isolated "headache" as the ADR. One drug was suspected in 47.4% of cases, two drugs in 29.1%, and three or more in 23.5%. In total, 473 suspected drugs, corresponding to 104 active ingredients, were involved, including analgesics (63.0%), in particular, acetaminophen-containing drugs, opioids, triptans and ergots, and non-steroidal anti-inflammatory drugs (12.7%). Antiepileptics and psycholeptics were found in 6.6% and 6.1% of cases, respectively. Drug withdrawal was successful in 84.6% of drug-discontinuation cases. Warnings about MOH are mentioned in the summary of product characteristics (SmPCs) for triptans, ergots, and certain acetaminophen-containing drugs, but not other drug classes.
    Conclusions: Certain drug classes show a high reporting rate of MOH and caution should be exercised when prescribing these drugs. Notably, warnings about MOH must be mentioned in the SmPC of all concerned drug classes.
    Language English
    Publishing date 2024-02-24
    Publishing country France
    Document type Journal Article
    ZDB-ID 603474-3
    ISSN 1958-5578 ; 0040-5957
    ISSN (online) 1958-5578
    ISSN 0040-5957
    DOI 10.1016/j.therap.2024.02.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Statin-induced myasthenia: A disproportionality analysis of the WHO's VigiBase pharmacovigilance database.

    Gras-Champel, Valerie / Batteux, Benjamin / Masmoudi, Kamel / Liabeuf, Sophie

    Muscle & nerve

    2019  Volume 60, Issue 4, Page(s) 382–386

    Abstract: Background: Statins have been linked to myasthenia gravis (MG) in recent case reports. However, MG is not currently listed as an adverse drug reaction (ADR) in the summary of product characteristics.: Methods: We performed case/noncase analyses in ... ...

    Abstract Background: Statins have been linked to myasthenia gravis (MG) in recent case reports. However, MG is not currently listed as an adverse drug reaction (ADR) in the summary of product characteristics.
    Methods: We performed case/noncase analyses in VigiBase® (the World Health Organization international database of suspected ADR) to identify a signal of MG (expressed as the reporting odds ratio [ROR] and its 95% confidence interval [CI]) for statins.
    Results: A total of 3967 reports mentioned MG. Of these, 169 were suspected to be statin-induced. A disproportionality signal was found for MG and statins use (ROR [95%CI] = 2.66 [2.28-3.10]).
    Conclusions: The present disproportionality analysis revealed a possible drug safety signal linking MG and statins. This potential signal is weak, and is offset by the cardiovascular benefits of statins. Clinicians should be aware of this potential ADR, because it may require consideration of statin withdrawal or treatment of MG.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Databases, Factual ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects ; Male ; Middle Aged ; Myasthenia Gravis/chemically induced ; Pharmacovigilance ; World Health Organization
    Chemical Substances Hydroxymethylglutaryl-CoA Reductase Inhibitors
    Language English
    Publishing date 2019-07-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 438353-9
    ISSN 1097-4598 ; 0148-639X
    ISSN (online) 1097-4598
    ISSN 0148-639X
    DOI 10.1002/mus.26637
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Statin therapy and the incidence of atherosclerotic cardiovascular events after kidney transplantation.

    Nazoiri, Charifa / Liabeuf, Sophie / Brazier, François / Nowak, Alban / Bennis, Youssef / Laville, Solène M / Bodeau, Sandra / Gras-Champel, Valérie / Masmoudi, Kamel / Choukroun, Gabriel / Batteux, Benjamin

    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

    2023  Volume 39, Issue 5, Page(s) 818–829

    Abstract: Background: Statins are recommended in kidney transplant recipients (KTRs)-a population with a high risk of major cardiovascular (CV) events. However, the literature data on the effectiveness of statins in KTRs are sparse and inconclusive. The present ... ...

    Abstract Background: Statins are recommended in kidney transplant recipients (KTRs)-a population with a high risk of major cardiovascular (CV) events. However, the literature data on the effectiveness of statins in KTRs are sparse and inconclusive. The present study's objective was to evaluate the association between statin exposure and atherosclerotic CV events in KTRs and the biochemical effectiveness of statins on the lipid profile.
    Methods: A total of 318 consecutive KTRs managed at a single center between 2006 and 2019 were retrospectively included. Those exposed to statins after transplantation were incident users. In all users, statins were indicated for primary CV prevention. Lipid profiles, the occurrence of any atherosclerotic CV events (stroke, myocardial infarction, other atherosclerotic CV events and atherosclerotic CV deaths) were documented comprehensively. We applied Cox models that included statin exposure as a time-dependent covariate fitted with time-varying inverse probability treatment weighting (IPTW) to assess the effectiveness of statins on atherosclerotic CV events and on all CV events. We built linear mixed models to assess the biochemical effectiveness of statins.
    Results: During a median (interquartile range) follow-up period of 6.0 (3.9-10.0) years, 27 atherosclerotic CV events occurred in 26 patients. In the Cox models fitted with time-varying IPTW, exposure to statins was not associated with a decrease in atherosclerotic CV events; the hazard ratio was 1.16 (95% confidence interval 0.53-2.53) (P = .700). In the linear mixed models, statin exposure was associated with significant decrease over time in triglyceride and low-density lipoprotein cholesterol concentrations (P < .001). These results were consistent when stratified for the intensity of statin therapy.
    Conclusion: Even though the lipid profile improved, statin exposure was not associated with a decrease in CV events in this real-life, single-center, retrospective, long-term follow-up study of a KTR cohort. Larger, controlled studies are needed to confirm or refute these results.
    MeSH term(s) Humans ; Kidney Transplantation/adverse effects ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Male ; Female ; Middle Aged ; Atherosclerosis/etiology ; Atherosclerosis/epidemiology ; Atherosclerosis/prevention & control ; Retrospective Studies ; Incidence ; Follow-Up Studies ; Adult ; Aged ; Prognosis ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/prevention & control ; Cardiovascular Diseases/epidemiology
    Chemical Substances Hydroxymethylglutaryl-CoA Reductase Inhibitors
    Language English
    Publishing date 2023-10-03
    Publishing country England
    Document type Journal Article
    ZDB-ID 90594-x
    ISSN 1460-2385 ; 0931-0509
    ISSN (online) 1460-2385
    ISSN 0931-0509
    DOI 10.1093/ndt/gfad217
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  6. Article ; Online: LPS

    Jeljeli, Mohamed / Chêne, Charlotte / Chouzenoux, Sandrine / Thomas, Marine / Segain, Benjamin / Doridot, Ludivine / Nicco, Carole / Batteux, Frédéric

    Frontiers in immunology

    2021  Volume 12, Page(s) 670776

    Abstract: Despite significant therapeutic advances, graft- ...

    Abstract Despite significant therapeutic advances, graft-
    MeSH term(s) Animals ; Carcinogenesis ; Cell Proliferation ; Cells, Cultured ; Cellular Reprogramming ; Female ; Graft vs Host Disease/immunology ; Hematopoietic Stem Cell Transplantation ; Immune Tolerance ; Interleukin-10/metabolism ; Lipopolysaccharides/metabolism ; Lymphoma/immunology ; Macrophages/immunology ; Macrophages/transplantation ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; T-Lymphocytes/immunology ; Transplantation, Homologous
    Chemical Substances Lipopolysaccharides ; Interleukin-10 (130068-27-8)
    Language English
    Publishing date 2021-08-03
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2606827-8
    ISSN 1664-3224 ; 1664-3224
    ISSN (online) 1664-3224
    ISSN 1664-3224
    DOI 10.3389/fimmu.2021.670776
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Statin-associated myasthenia: A case report and literature review.

    Gras-Champel, Valérie / Masmoudi, Inès / Batteux, Benjamin / Merle, Philippe-Edouard / Liabeuf, Sophie / Masmoudi, Kamel

    Therapie

    2019  Volume 75, Issue 3, Page(s) 301–309

    MeSH term(s) Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects
    Chemical Substances Hydroxymethylglutaryl-CoA Reductase Inhibitors
    Language English
    Publishing date 2019-07-26
    Publishing country France
    Document type Case Reports ; Letter ; Review
    ZDB-ID 603474-3
    ISSN 1958-5578 ; 0040-5957
    ISSN (online) 1958-5578
    ISSN 0040-5957
    DOI 10.1016/j.therap.2019.07.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Rheumatic and musculoskeletal disorders induced by immune checkpoint inhibitors: Consequences on overall survival.

    Adda, Leslie / Batteux, Benjamin / Saidak, Zuzana / Poulet, Claire / Arnault, Jean-Philippe / Chauffert, Bruno / Séjourné, Alice

    Joint bone spine

    2021  Volume 88, Issue 4, Page(s) 105168

    Abstract: Objectives: Immune checkpoint inhibitors (ICIs) frequently induce immune related adverse events (irAEs) that may be associated with more favorable clinical outcomes. We aimed to evaluate the impact of all types of rheumatic adverse events (AEs) on ... ...

    Abstract Objectives: Immune checkpoint inhibitors (ICIs) frequently induce immune related adverse events (irAEs) that may be associated with more favorable clinical outcomes. We aimed to evaluate the impact of all types of rheumatic adverse events (AEs) on overall survival (OS) and tumor response in patients treated with ICIs.
    Methods: We performed a single-center retrospective observational study to analyze the OS and tumor response in patients receiving ICIs who experienced a rheumatic AE compared to those who did not experience any AE.
    Results: From December 2010 to September 2018, 264 patients with any cancer type were included. Forty-three patients (16.3%) presented with at least one rheumatic AE. The median OS of patients with rheumatic AEs was significantly higher than that of patients without AEs, with 132 weeks (95% CI [69.3-not reached]) and 42.7 weeks (95% CI [25.6-not reached]), respectively (P<0.01). This result remained significant after multivariate analysis (HR 0.54, 95% CI [0.30-0.97], P<0.05). Also, tumor response was better in patients with rheumatic AEs.
    Conclusion: The occurrence of rheumatic AEs in patients treated with ICIs is associated with better survival and tumor response. Therefore, it seems essential to detect rheumatic AEs as early as possible to allow rapid and optimal management, given the long-term response potential of these patients.
    MeSH term(s) Humans ; Immune Checkpoint Inhibitors ; Musculoskeletal Diseases ; Neoplasms ; Retrospective Studies
    Chemical Substances Immune Checkpoint Inhibitors
    Language English
    Publishing date 2021-03-03
    Publishing country France
    Document type Journal Article ; Observational Study
    ZDB-ID 2020487-5
    ISSN 1778-7254 ; 1297-319X
    ISSN (online) 1778-7254
    ISSN 1297-319X
    DOI 10.1016/j.jbspin.2021.105168
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Associations between osteoporosis and drug exposure: A post-marketing study of the World Health Organization pharmacovigilance database (VigiBase®).

    Batteux, Benjamin / Bennis, Youssef / Bodeau, Sandra / Masmoudi, Kamel / Hurtel-Lemaire, Anne-Sophie / Kamel, Said / Gras-Champel, Valérie / Liabeuf, Sophie

    Bone

    2021  Volume 153, Page(s) 116137

    Abstract: Background: Bone remodeling is a complex process, and many conditions (including drug exposure) lead to osteoporosis. Here, we sought to detect new disproportionality signals for drugs associated with osteoporosis.: Methods: We performed a ... ...

    Abstract Background: Bone remodeling is a complex process, and many conditions (including drug exposure) lead to osteoporosis. Here, we sought to detect new disproportionality signals for drugs associated with osteoporosis.
    Methods: We performed a disproportionality analysis of the World Health Organization's VigiBase® pharmacovigilance database through April 12, 2020. The frequency of reports on osteoporosis for all identified drug classes was compared with that for all other drugs and quoted as the reporting odds ratio (ROR) [95% confidence interval (CI)].
    Results: Of the 7,594,968 cases spontaneously recorded to VigiBase®, 4758 concerned osteoporosis. New disproportionality signals with a pharmacologically plausible mechanism were found for drugs used in neurology (levodopa (ROR [95%CI]: 10.18 [4.33-25.10]), selective serotonin agonists (4.22 [2.34-7.00]) and memantine (4.10 [1.56-8.93])), hematology (romiplostim (4.93 [1.15-21.10])), pulmonology (macitentan (3.02 [1.84-4.90])), ophthalmology (ranibizumab (3.31 [1.00-10.51])) and rheumatology (tofacitinib (3.65 [3.00-4.40])). The robustness of these new results is supported by the significant RORs for the vast majority of drugs already known to induce osteoporosis and/or increase the fracture risk, namely glucocorticoids, gonadotropin-releasing hormone analogs, anti-aromatases, androgen receptor blockers, thyroid hormones, proton pump inhibitors, thiazolidinediones, vitamin K antagonists, loop diuretics, protease inhibitors, nucleoside and nucleotide reverse transcriptase inhibitors, and enzyme-inducing antiepileptics including barbiturates and derivatives, hydantoin derivatives, carboxamide derivatives and fatty acid derivatives.
    Conclusion: We established up a comprehensive list of drugs potentially associated with osteoporosis and highlighted those with pharmacologically plausible mechanisms leading to bone fragility. Our results might pave the way for additional exploration of these mechanisms.
    MeSH term(s) Adverse Drug Reaction Reporting Systems ; Databases, Factual ; Humans ; Marketing ; Osteoporosis/chemically induced ; Osteoporosis/drug therapy ; Osteoporosis/epidemiology ; Pharmaceutical Preparations ; Pharmacovigilance ; World Health Organization
    Chemical Substances Pharmaceutical Preparations
    Language English
    Publishing date 2021-07-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632515-4
    ISSN 1873-2763 ; 8756-3282
    ISSN (online) 1873-2763
    ISSN 8756-3282
    DOI 10.1016/j.bone.2021.116137
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: COVID-19 in DMARD-treated patients with inflammatory rheumatic diseases: Insights from an analysis of the World Health Organization pharmacovigilance database.

    Dernoncourt, Amandine / Schmidt, Jean / Duhaut, Pierre / Liabeuf, Sophie / Gras-Champel, Valérie / Masmoudi, Kamel / Bennis, Youssef / Batteux, Benjamin

    Fundamental & clinical pharmacology

    2021  Volume 36, Issue 1, Page(s) 199–209

    Abstract: Background: To determine whether the use of disease-modifying antirheumatic drugs (DMARDs) is linked to the risk of COVID-19 among patients with inflammatory rheumatic diseases (IRDs).: Methods: We performed a disproportionality analysis of the World ...

    Abstract Background: To determine whether the use of disease-modifying antirheumatic drugs (DMARDs) is linked to the risk of COVID-19 among patients with inflammatory rheumatic diseases (IRDs).
    Methods: We performed a disproportionality analysis of the World Health Organization pharmacovigilance database between January 1, 2020, and June 10, 2020. The frequency of COVID-19 reports for all DMARD classes identified was compared with that for all other reports for all other drugs and quoted as the reporting odds ratio (ROR) (95% confidence interval [CI]).
    Results: Among 980,446 individual case-safety reports voluntarily recorded in the database, 398 identified COVID-19 in DMARD-treated patients with IRDs. There were 177 (44.5%) patients with rheumatoid arthritis (RA), 120 (30.1%) with ankylosing spondylitis (AS), 93 (23.4%) with psoriatic arthritis (PsA), and 8 (2.0%) with juvenile idiopathic arthritis. Most of the cases of COVID-19 occurred in patients taking anti-TNF agents (84.2%), resulting in a significant disproportionality signal (ROR [95% CI]: 8.31 [7.48-9.23]) - particularly in patients with RA, AS or PsA. A significant inverse disproportionality was found for the anti-IL-6 agent tocilizumab (ROR [95% CI]: 0.12 [0.02-0.88]) and JAK inhibitors (ROR [95% CI]: 0.33 [0.19-0.58]) in patients with RA - suggesting that these two drug classes are safer in the context of RA.
    Conclusion: Our results are in line with the literature on a potentially better safety profile for anti-IL-6 agents and JAK inhibitors. The WHO pharmacovigilance data suggest that COVID-19 is significantly more frequent in patients with IRDs treated with TNF inhibitors.
    MeSH term(s) Antirheumatic Agents/adverse effects ; Arthritis, Rheumatoid/diagnosis ; Arthritis, Rheumatoid/drug therapy ; Arthritis, Rheumatoid/epidemiology ; COVID-19 ; Humans ; Pharmacovigilance ; SARS-CoV-2 ; Tumor Necrosis Factor Inhibitors ; World Health Organization
    Chemical Substances Antirheumatic Agents ; Tumor Necrosis Factor Inhibitors
    Language English
    Publishing date 2021-05-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 639134-5
    ISSN 1472-8206 ; 0767-3981
    ISSN (online) 1472-8206
    ISSN 0767-3981
    DOI 10.1111/fcp.12695
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