Use of non-steroidal anti-inflammatory drugs and risk of death from COVID-19: an OpenSAFELY cohort analysis based on two cohorts
Wong et al.,
Use of non-steroidal anti-inflammatory drugs and risk of death from COVID-19: an OpenSAFELY cohort analysis..,
Annals of the Rheumatic Diseases, doi:10.1136/annrheumdis-2020-219517
Retrospective 2,463,707 people in the UK, showing no significant difference in COVID-19 mortality with NSAID use. Current NSAID users were defined as those ever prescribed an NSAID in the 4 months prior to study start, and non-users were those with no record of NSAID prescription in the same time period.
risk of death, 23.0% higher, HR 1.23, p = 0.19, adjusted per study, general population, multivariable.
|
risk of death, 17.0% lower, HR 0.83, p = 0.37, adjusted per study, rheumatoid arthritis/osteoarthritis patients, multivariable.
|
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
|
Wong et al., 21 Jan 2021, retrospective, United Kingdom, peer-reviewed, median age 53.0, 32 authors, study period 1 March, 2020 - 14 June, 2020.
Abstract: CLINICAL SCIENCE
Use of non-steroidal anti-inflammatory drugs and risk
of death from COVID-19: an OpenSAFELY cohort
analysis based on two cohorts
Angel YS Wong ,1 Brian MacKenna,2 Caroline E Morton,2 Anna Schultze,1
Alex J Walker,2 Krishnan Bhaskaran,1 Jeremy P Brown,1 Christopher T Rentsch,1
Elizabeth Williamson,1 Henry Drysdale,2 Richard Croker,2 Seb Bacon,2 William Hulme,2
Chris Bates,3 Helen J Curtis,2 Amir Mehrkar,2 David Evans,2 Peter Inglesby,2
Jonathan Cockburn,3 Helen I McDonald,1 Laurie Tomlinson,1 Rohini Mathur,1
Kevin Wing,1 Harriet Forbes,1 Rosalind M Eggo,1 John Parry,3 Frank Hester,3
Sam Harper,3 Stephen JW Evans,1 Liam Smeeth,1 Ian J Douglas,1 Ben Goldacre,2 The
OpenSAFELY Collaborative
Handling editor Josef S
Smolen
►► Additional material is
published online only. To view,
please visit the journal online
(http://d x.doi.o rg/10.1136/
annrheumdis-2020-219517).
1
Department of Non-
Communicable Disease
Epidemiology, London School
of Hygiene & Tropical Medicine,
London, UK
2
The DataLab, Nuffield
Department of Primary Care
Health Sciences, University of
Oxford, Oxford, UK
3
TPP, Leeds, UK
Correspondence to
Dr Angel YS Wong, London
School of Hygiene & Tropical
Medicine, London, UK;
a ngel.wong@l shtm.ac.uk
AYW, BM and CEM contributed
equally.
Received 16 November 2020
Revised 8 January 2021
Accepted 8 January 2021
Published Online First
21 January 2021
ABSTRACT
Objectives To assess the association between routinely
prescribed non-steroidal anti-inflammatory drugs
(NSAIDs) and deaths from COVID-19 using OpenSAFELY,
a secure analytical platform.
Methods We conducted two cohort studies from 1
March to 14 June 2020. Working on behalf of National
Health Service England, we used routine clinical data in
England linked to death data. In study 1, we identified
people with an NSAID prescription in the last 3 years
from the general population. In study 2, we identified
people with rheumatoid arthritis/osteoarthritis. We
defined exposure as current NSAID prescription within
the 4 months before 1 March 2020. We used Cox
regression to estimate HRs for COVID-19 related death in
people currently prescribed NSAIDs, compared with those
not currently prescribed NSAIDs, accounting for age,
sex, comorbidities, other medications and geographical
region.
Results In study 1, we included 536 423 current
NSAID users and 1 927 284 non-users in the general
population. We observed no evidence of difference
in risk of COVID-19 related death associated with
current use (HR 0.96, 95% CI 0.80 to 1.14) in the
multivariable-adjusted model. In study 2, we included 1
708 781 people with rheumatoid arthritis/osteoarthritis,
of whom 175 495 (10%) were current NSAID users. In
the multivariable-adjusted model, we observed a lower
risk of COVID-19 related death (HR 0.78, 95% CI 0.64
to 0.94) associated with current use of NSAID versus
non-use.
Conclusions We found no evidence of a harmful effect
of routinely prescribed NSAIDs on COVID-19 related
deaths. Risks of COVID-19 do not need to influence
decisions about the routine therapeutic use of NSAIDs.
© Author(s) (or their
employer(s)) 2021. Re-use
permitted under CC BY.
Published by BMJ.
wong4
Please send us corrections, updates, or comments. Vaccines and
treatments are complementary. All practical, effective, and safe means should
be used based on risk/benefit analysis. No treatment, vaccine, or intervention
is 100% available and effective for all current and future variants. We do not
provide medical advice. Before taking any medication, consult a qualified
physician who can provide personalized advice and details of risks and
benefits based on your medical history and situation.
FLCCC and
WCH
provide treatment protocols.
Submit