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Risk of COVID-19 Diagnosis and Hospitalization in Patients with Osteoarthritis or Back Pain Treated with Ibuprofen Compared to Other NSAIDs or Paracetamol: A Network Cohort Study

Xie et al., Drugs, doi:10.1007/s40265-022-01822-z (date from preprint)
Jul 2022  
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Hospitalization -5% Improvement Relative Risk Case 3% Acetaminophen for COVID-19  Xie et al.  Prophylaxis Is prophylaxis with acetaminophen beneficial for COVID-19? Retrospective 1,370,600 patients in the USA (Feb - Oct 2020) Study compares with ibuprofen, results vs. placebo may differ No significant difference in outcomes seen c19early.org Xie et al., Drugs, July 2022 Favorsacetaminophen Favorsibuprofen 0 0.5 1 1.5 2+
2nd treatment shown to increase risk in November 2020, now with p = 0.00000029 from 27 studies, but still recommended in 64 countries.
5,100+ studies for 112 treatments. c19early.org
PSM retrospective 1,370,600 osteoarthritis or back pain patients in the US, showing no significant differences in COVID-19 cases and hospitalization for paracetamol vs. ibuprofen.
Paracetamol is also known as acetaminophen, Tylenol, Panadol, Calpol, Tempra, Calprofen, Doliprane, Efferalgan, Grippostad C, Dolo, Acamol, Fevadol, Crocin, and Perfalgan.
Study covers ibuprofen and acetaminophen.
risk of hospitalization, 4.8% higher, HR 1.05, p = 0.83, inverted to make HR<1 favor treatment, Open Claims, PharMetrics Plus, both periods combined.
risk of case, 3.5% lower, HR 0.97, p = 0.82, inverted to make HR<1 favor treatment, Open Claims, PharMetrics Plus, both periods combined.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Xie et al., 13 Jul 2022, retrospective, USA, peer-reviewed, 9 authors, study period 1 February, 2020 - 31 October, 2020, this trial compares with another treatment - results may be better when compared to placebo.
This PaperAcetaminophenAll
Risk of COVID-19 Diagnosis and Hospitalisation in Patients with Osteoarthritis or Back Pain Treated with Ibuprofen Compared to Other NSAIDs or Paracetamol: A Network Cohort Study
Junqing Xie, James T Brash, Cigdem Turkmen, Stefan Driessen, Giustino Varrassi, George Argyriou, Sarah Seager, Christian Reich, Daniel Prieto-Alhambra
Drugs, doi:10.1007/s40265-022-01822-z
Objective We aimed to investigate whether ibuprofen use, compared with other non-selective non-steroidal anti-inflammatory drugs (ns-NSAIDs), cyclooxygenase-2 inhibitors (COX-2i) or paracetamol, increases the risk of coronavirus disease 2019 (COVID-19) diagnosis or hospitalisation. Design A prevalent user and active comparator cohort study. Setting Two US claims databases (Open Claims and PharMetrics Plus) mapped to the Observational Medical Outcomes Partnership Common Data Model. Participants Insured patients with a history of osteoarthritis or back pain and receiving ibuprofen, other ns-NSAIDs, COX-2i or paracetamol between
or paracetamol, was not associated with an increased risk of susceptibility and severity of COVID-19. Supplementary Information The online version contains supplementary material available at https:// doi. org/ 10. 1007/ s40265-022-01822-z. Declarations Funding Abbott contracted IQVIA for the conduct of this study. Prof. Prieto-Alhambra receives funding from the UK National Institute for Health Research in the form of a Senior Research Fellowship, and as part of the Oxford National Institute for Health Research Biomedical Research Centre. Prof. Giustino Varrassi had a contract with Abbott International, as a consultant for scientific projects. He is also a consultant for scientific projects with Dompé Farmaceutici and Menarini Group. Ethics Approval These assets are de-identified, commercially available data products that could be purchased and licensed by any researcher. The collection and de-identification of these data assets is a process that is commercial intellectual property and not privileged to the data licensees and the co-authors on this study. Licensees of these data have signed data use agreements with the data vendors that detail the usage protocols for running retrospective research on these databases. All analyses performed in this study were in accordance with data use agreement terms as specified by the data owners. As these data are deemed commercial assets, there is no institutional review board applicable to the usage and dissemination of these result..
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' '2015;11:1061–75. https://doi.org/10.2147/TCRM.S79135.', 'journal-title': 'Ther Clin Risk Manag'}], 'container-title': 'Drugs', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://link.springer.com/content/pdf/10.1007/s40265-022-01822-z.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/article/10.1007/s40265-022-01822-z/fulltext.html', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/content/pdf/10.1007/s40265-022-01822-z.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2023, 2, 15]], 'date-time': '2023-02-15T07:30:28Z', 'timestamp': 1676446228000}, 'score': 1, 'resource': {'primary': {'URL': 'https://link.springer.com/10.1007/s40265-022-01822-z'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2023, 1, 24]]}, 'references-count': 28, 'journal-issue': {'issue': '3', 'published-print': {'date-parts': [[2023, 2]]}}, 'alternative-id': ['1822'], 'URL': 'http://dx.doi.org/10.1007/s40265-022-01822-z', 'relation': {}, 'ISSN': ['0012-6667', '1179-1950'], 'subject': ['Pharmacology (medical)'], 'container-title-short': 'Drugs', 'published': {'date-parts': [[2023, 1, 24]]}, 'assertion': [ { 'value': '27 November 2022', 'order': 1, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '24 January 2023', 'order': 2, 'name': 'first_online', 'label': 'First Online', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, {'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Declarations'}}, { 'value': 'Abbott contracted IQVIA for the conduct of this study. Prof. Prieto-Alhambra ' 'receives funding from the UK National Institute for Health Research in the form ' 'of a Senior Research Fellowship, and as part of the Oxford National Institute ' 'for Health Research Biomedical Research Centre. Prof. Giustino Varrassi had a ' 'contract with Abbott International, as a consultant for scientific projects. He ' 'is also a consultant for scientific projects with Dompé Farmaceutici and ' 'Menarini Group.', 'order': 2, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Funding'}}, { 'value': 'All authors have completed the ICMJE disclosure form at ExternalRef removed and ' 'declare the following interests: Dani Prieto-Alhambra receives funding from the ' 'UK National Institute for Health Research in the form of a senior research ' 'fellowship and from the Oxford National Institute for Health Research ' 'Biomedical Research Centre. Junqing Xie receives the Clarendon Fund and Jardine ' 'scholarship (University of Oxford) to support her DPhil study. Dani ' 'Prieto-Alhambra’s research group has received research grants from the European ' 'Medicines Agency, the Innovative Medicines Initiative, Amgen, Chiesi and UCB ' 'Biopharma; and consultancy or speaker fees from Astellas, Amgen, AstraZeneca ' 'and UCB Biopharma.', 'order': 3, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Conflicts of Interest/Competing Interests'}}, { 'value': 'These assets are de-identified, commercially available data products that could ' 'be purchased and licensed by any researcher. The collection and ' 'de-identification of these data assets is a process that is commercial ' 'intellectual property and not privileged to the data licensees and the ' 'co-authors on this study. Licensees of these data have signed data use ' 'agreements with the data vendors that detail the usage protocols for running ' 'retrospective research on these databases. All analyses performed in this study ' 'were in accordance with data use agreement terms as specified by the data ' 'owners. As these data are deemed commercial assets, there is no institutional ' 'review board applicable to the usage and dissemination of these result sets or ' 'required registration of the protocol with additional ethics oversight. ' 'Compliance with data use agreement terms, which stipulate how these data can be ' 'used and for what purpose, is sufficient for the licensing commercial entities.', 'order': 4, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Ethics Approval'}}, { 'value': 'Not applicable.', 'order': 5, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Consent to Participate'}}, { 'value': 'Not applicable.', 'order': 6, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Consent for Publication'}}, { 'value': 'Patient-level data cannot be shared without approval from data custodians owing ' 'to local information governance and data protection regulations. Additional ' 'summary data, analytical code and detailed definitions of algorithms for ' 'identifying the events are available from the corresponding author on ' 'reasonable request to access the GitHub repository.', 'order': 7, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Availability of Data and Material'}}, { 'value': 'Not applicable.', 'order': 8, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Code Availability'}}, { 'value': 'JQ-X, DP-A, SS, CT and GV conceived the study and contributed to the study ' 'design. JQ-X, JB and JA conducted the statistical analyses. JQ-X and DP-A ' 'interpreted the results and wrote the manuscript. All authors contributed to ' 'writing the manuscript, approved the final version and had final responsibility ' 'for the decision to submit for publication. The lead authors (JQ-X and JB) ' 'affirm that this manuscript is an honest, accurate and transparent account of ' 'the study being reported, that no important aspects of the study have been ' 'omitted and that any discrepancies from the study as planned (and, if relevant, ' 'registered) have been explained. DP-A is the guarantor. The corresponding ' 'author attests that all listed authors meet authorship criteria and that no ' 'others meeting the criteria have been omitted.', 'order': 9, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Authors’ Contributors'}}]}
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