Some Arthritis Meds Raise Risks in Latest COVID Spike
Most people experience mild symptoms, but patients who take JAK inhibitors are at higher risk of worse outcomes.
By Linda Rath | Aug. 16, 2023
This summer, like the last three, has seen a spike in COVID-19 infections and hospitalizations. The current culprit is an omicron subvariant called EG.5 or Eris, which now accounts for most cases in the U.S., according to CDC tracking data. So far, new infections haven’t increased as much as in past years, and most people are reporting milder symptoms. The risk of hospitalization is also less — just 18% of the number of COVID-related hospitalizations in July 2022.
It’s not clear why the coronavirus surges in summer. Experts speculate that hot weather drives more people indoors together, plus natural immunity has probably waned this year and current vaccines and boosters aren’t effective against newer variants.
Scientists aren’t sounding the alarm just yet, though. According to Andrew Pekosz, PhD, professor and vice chair of the department of molecular microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health, “There’s nothing concerning about this variant when we look at its sequence — it just seems to be spreading faster than other recent variants.”
But Pekosz and others also say that people who are immunocompromised or take medications that weaken the immune system should take extra precautions, including masking in crowded public spaces and washing their hands thoroughly and often.
People who have rheumatoid arthritis (RA) treated with Janus kinase (JAK) inhibitors need to be especially careful.
According to a study published in Rheumatic and Musculoskeletal Diseases in July 2023, patients taking these drugs are significantly more likely to be hospitalized or have poor outcomes, including mortality, compared to those treated with an interleukin-6 (IL-6) inhibitor like tocilizumab (Actemra) or a tumor necrosis factor (TNF) blocker, such as adalimumab (Humira or one of its biosimilars) or etanercept (Enbrel).
Researchers used data from TriNetX, the largest global COVID-19 real-time database. It showed that the incidence of coronavirus infection didn’t vary much among patients on different types of arthritis drugs. But people treated with JAK inhibitors who became infected were nearly twice as likely to be hospitalized and one-and-one-half times more likely to die.
Outcomes were even worse for those patients taking JAK inhibitors who are not vaccinated.
The researchers strongly recommend the COVID-19 vaccine for people taking a JAK inhibitor or rituximab (Rituxan), which in an earlier study were associated with a greater than quadrupled risk of hospitalization and death.
Most experts advise waiting for the updated boosters slated to roll out in late September. The new shots are expected to be a better, though not perfect match for EG.5 and similar variants.
The government has handed over the distribution of the boosters to the three U.S. vaccine makers, so they may not be as readily available as before. And the government will no longer be buying them. But Medicare and commercial insurance plans are required to cover them without cost-sharing, and updated boosters will be free for the uninsured and adults and children on Medicaid for one year. The intent is that consumers will not have to shoulder the costs.
This summer, like the last three, has seen a spike in COVID-19 infections and hospitalizations. The current culprit is an omicron subvariant called EG.5 or Eris, which now accounts for most cases in the U.S., according to CDC tracking data. So far, new infections haven’t increased as much as in past years, and most people are reporting milder symptoms. The risk of hospitalization is also less — just 18% of the number of COVID-related hospitalizations in July 2022.
It’s not clear why the coronavirus surges in summer. Experts speculate that hot weather drives more people indoors together, plus natural immunity has probably waned this year and current vaccines and boosters aren’t effective against newer variants.
Scientists aren’t sounding the alarm just yet, though. According to Andrew Pekosz, PhD, professor and vice chair of the department of molecular microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health, “There’s nothing concerning about this variant when we look at its sequence — it just seems to be spreading faster than other recent variants.”
But Pekosz and others also say that people who are immunocompromised or take medications that weaken the immune system should take extra precautions, including masking in crowded public spaces and washing their hands thoroughly and often.
People who have rheumatoid arthritis (RA) treated with Janus kinase (JAK) inhibitors need to be especially careful.
According to a study published in Rheumatic and Musculoskeletal Diseases in July 2023, patients taking these drugs are significantly more likely to be hospitalized or have poor outcomes, including mortality, compared to those treated with an interleukin-6 (IL-6) inhibitor like tocilizumab (Actemra) or a tumor necrosis factor (TNF) blocker, such as adalimumab (Humira or one of its biosimilars) or etanercept (Enbrel).
Researchers used data from TriNetX, the largest global COVID-19 real-time database. It showed that the incidence of coronavirus infection didn’t vary much among patients on different types of arthritis drugs. But people treated with JAK inhibitors who became infected were nearly twice as likely to be hospitalized and one-and-one-half times more likely to die.
Outcomes were even worse for those patients taking JAK inhibitors who are not vaccinated.
The researchers strongly recommend the COVID-19 vaccine for people taking a JAK inhibitor or rituximab (Rituxan), which in an earlier study were associated with a greater than quadrupled risk of hospitalization and death.
Most experts advise waiting for the updated boosters slated to roll out in late September. The new shots are expected to be a better, though not perfect match for EG.5 and similar variants.
The government has handed over the distribution of the boosters to the three U.S. vaccine makers, so they may not be as readily available as before. And the government will no longer be buying them. But Medicare and commercial insurance plans are required to cover them without cost-sharing, and updated boosters will be free for the uninsured and adults and children on Medicaid for one year. The intent is that consumers will not have to shoulder the costs.
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