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- systemic vasculitis
- rituximab
- communicable diseases, imported
- granulomatosis with polyangiitis
- hydroxychloroquine
In the pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease 2019 (covid-19),1 2 the preliminary experience reported by Monti S and colleagues3 suggests that patients with chronic arthritis (rheumatoid arthritis and spondyloarthritis) receiving bDMARDs (biologic disease-modifying anti-rheumatic drugs) or tsDMARDs (targeted synthetic DMARDs) may not exhibit an increased risk of severe covid-19. These data must be strengthened and confirmed at a larger scale, but remain positive in this drastic context. The authors rightly recommend a continuous surveillance of patients under immunosuppressants, especially since data are lacking in many systemic autoimmune/inflammatory diseases. Notably, anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) is a group of vasculitides that can involve the respiratory tract (upper and lower airways) and the recent outbreak of covid-19 raises many specific questions concerning the severity of viral infection in AAV patients as well as the therapy with rituximab. Indeed, rituximab, a monoclonal antibody targeting CD20, has become the cornerstone of treatment in the last decade, but is responsible for long-lasting B-cell depletion and potentially severe infectious events (IE) independently from covid-19.4 A recent observation from our centre illustrates some specific issues with this drug.
A 52-year-old woman was followed for granulomatosis …
Footnotes
Contributors All authors have contributed to this manuscript and fulfil the requirements for authorship.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests PG has been a medical expert for LFB (Laboratoire Français du Biofractionnement) and has received fees from Abbvie, Actelion, Boehringer Ingelheim France, Bouchara-Recordati, Novartis, Pfizer and Roche in the last 5 years. ATJM has received fees from Abbvie, Actelion, CSL Behring, Experf, Novartis and Shire and declares speaking fees from Astra-Zeneca and BMS in the last 5 years.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.
Patient consent for publication Obtained.
Provenance and peer review Not commissioned; internally peer reviewed.