Soldevila-Domenech, NataliaTío, LauraLlorente Onaindia, JoneMartín García, Elena, 1975-Nebot Forcada, PauTorre Fornell, Rafael de laGurt, AlbaMaldonado, Rafael, 1961-Monfort, JordiCovidmar Study Group2021-02-152021-02-152020Soldevila-Domenech N, Tío L, Llorente-Onaindia J, Martín-García E, Nebot P, de la Torre R, Gurt A, Maldonado R, Monfort J; Covidmar Study Group. COVID-19 incidence in patients with immunomediated inflammatory diseases: influence of immunosuppressant treatments. Front Pharmacol. 2020; 11:583260. DOI: 10.3389/fphar.2020.5832601663-9812http://hdl.handle.net/10230/46471The effect of immunosuppressant treatments on the incidence of coronavirus disease (COVID-19) remains largely unknown. We studied the association between the pre-exposure to disease-modifying antirheumatic drugs (DMARDs) that decrease immunological responses and the incidence of COVID-19 to explore the possible effects of these treatments in early manifestations of the disease. For this purpose, we performed a cross-sectional study including 2,494 patients with immunomediated inflammatory diseases (IMIDs) recruited at the outpatient Rheumatology, Dermatology and Gastroenterology services of Hospital del Mar. The primary outcome was the clinical diagnosis of COVID-19 performed by a physician at the hospital or at the primary care center, from the March 1-29, 2020. Multivariable Poisson regression models were fitted to estimate COVID-19 relative risk (RR) adjusted by comorbidities. We revealed that biological (RR = 0.46, CI 95% = 0.31-0.67) and synthetic (RR = 0.62, CI 95% = 0.43-0.91) DMARDs used in IMIDs diminished the incidence of COVID-19. Striking sex differences were revealed with anti-TNFα compounds (RR = 0.50, CI 95% = 0.33-0.75) with higher effects in women (RR = 0.33, CI 95% = 0.17-0.647). Treatment with low glucocorticoid doses also revealed sex differences decreasing the incidence of COVID-19 predominantly in women (RR = 0.72, CI 95% = 0.42-1.22). Our results report a decreased incidence of COVID-19 in patients receiving specific DMARDs with different immunodepressor mechanisms with striking sex differences. These results underline the interest of repurposing specific DMARDs for the possibility of minimizing the severity of disease progression in the early stages of COVID-19.application/pdfeng© 2020 Soldevila-Domenech, Tío, Llorente‐Onaindia, Martín‐García, Nebot, de la Torre, Gurt, Maldonado and Monfort. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.info:eu-repo/semantics/articlehttp://dx.doi.org/10.3389/fphar.2020.583260Biological therapyCross-sectional studyDisease modifying antirheumatic drugs (DMARDs)GenderGlucocorticoidsRelative riskTumor necrosis factor inhibitorinfo:eu-repo/semantics/openAccess