P0783 - Efficacy of Remdesivir for COVID-19 Infection in Patients With Inflammatory Bowel Disease: A Propensity-Matched Study

Sunday, October 22, 2023

3:30 PM – 7:00 PM PT

Location: Exhibit Hall

Presenting Author(s)

Khaled Alsabbagh Alchirazi, MD

Cleveland Clinic
Cleveland, OH

Khaled Alsabbagh Alchirazi, MD¹, Aakash Desai, MD², Manasik Abdu, MD³, Thabet Qapaja, MD¹, Osama Hamid, MD, MRCPI¹, Alia Khamis, MD⁴, Miguel Regueiro, MD⁵
¹Cleveland Clinic, Cleveland, OH; ²MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH; ³University at Buffalo-Catholic Health System, Buffalo, NY; ⁴University of Rochester Medical Center, Rochester, NY; ⁵Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH

Introduction: Inflammatory bowel disease (IBD) affects around 1.3% of the US adult population (3 million) as of 2015. IBD patients receiving immune suppressive therapy are at increased risk of developing severe COVID-19 (coronavirus) infection. Remdesivir (RDV), an RNA inhibitor, is an FDA-approved antiviral for mild-to-severe COVID-19. The effect of using RDV in IBD patients hasn't been studied adequately. We aim to compare COVID-19 outcomes in hospitalized IBD patients who did and didn't receive RDV.

Methods: A retrospective cohort study was performed using TriNetX (Cambridge, MA) which provides real-time access to deidentified electronic health records of more than 78 million patients. Patients with IBD with COVID-19 infection were identified using ICD-10 codes. We identified patients who received Remdesivir. The IBD control cohort included patients with IBD and COVID-19 who did not receive RDV. We compared several COVID-19 related complications and utilization rate of IV/PO steroids in IBD patients with and without RDV. 1:1 propensity-score matching was performed for age, gender, race, ethnicity, comorbid diseases, IBD types, and IBD medications between the RDV and control cohorts. Adjusted odds ratios (aOR) with 95% confidence interval (CI) were calculated.

Results: After matching, a total of 917 patients with IBD and COVID-19 received RDV (mean age 64.1 ±16.2 y; female 55.54%). The risk of acute respiratory distress syndrome (ARDS) was higher in the RDV group (aOR 2.09, 95% CI, 1.22–3.61) compared with IBD control. There was no difference in risk of requiring ICU care (aOR, 1.07; 95% CI, 0.80–1.43), mechanical intubation (aOR, 1.6; 95% CI, 0.97–2.64), venous thromboembolism (VTE) (aOR, 1.27; 95% CI, 0.97–1.66), myocardial infarction(MI) (aOR, 0.75; 95% CI, 0.51–1.12). Lastly, there was no difference in IBD outcomes when utilizing oral vs. intravenous corticosteroids between the RDV and IBD control cohort, Table 1.

Discussion: After propensity score matching and when comparing COVID-19 outcomes in IBD patients who did and didn’t receive RDV, our study concludes that there was no significant difference between the two groups. Furthermore, RDV wasn’t associated with a negative impact on the clinical course of IBD and its use for COVID-19 treatment in this population shouldn’t be discouraged.

Outcome		N (%)	OR (95% CI), p value
ICU care	Remdesivir	110 (11.9%)	1.07 (0.8-1.43), 0.6
	Control	103 (11.2%)	1.07 (0.8-1.43), 0.6
Intubation	Remdesivir	41 (4,4%)	1.6 (0.97-2.64), 0.06
	Control	26 (2.8%)	1.6 (0.97-2.64), 0.06
Mortality	Remdesivir	96 (10.4%)	1.46 (1.05-2.02), 0.02
	Control	68 (7.4%)	1.46 (1.05-2.02), 0.02
ARDS	Remdesivir	41 (4.4%)	2.09 (1.22-3.61), 0.006
	Control	20 (2.1%)	2.09 (1.22-3.61), 0.006
VTE	Remdesivir	137 (14.9%)	1.27 (0.97-1.66). 0.07
	Control	111 (12.1%)	1.27 (0.97-1.66). 0.07
MI	Remdesivir	47 (5.1%)	0.75 (0.51-1.12), 0.16
	Control	61 (6.6%)	0.75 (0.51-1.12), 0.16
IV/PO steroids	Remdesivir	175 (18.9%)	1.12 (0.88-1.42), 0.33
	Control	159 (17.2%)	1.12 (0.88-1.42), 0.33

Table: Table 1: Outcomes of COVID-19 in IBD Patients in the Remdesivir Cohort Compared With the IBD Control Cohort After Propensity-Score Matching.

Disclosures:

Khaled Alsabbagh Alchirazi indicated no relevant financial relationships.

Aakash Desai indicated no relevant financial relationships.

Manasik Abdu indicated no relevant financial relationships.

Thabet Qapaja indicated no relevant financial relationships.

Osama Hamid indicated no relevant financial relationships.

Alia Khamis indicated no relevant financial relationships.

Miguel Regueiro: AbbVie – Advisory Committee/Board Member, Consultant, Unrestricted educational grants. Alfasigma – Advisory Committee/Board Member, Consultant. Allergan – Advisory Committee/Board Member, Consultant. Amgen – Advisory Committee/Board Member, Consultant. Bristol Myers Squibb – Advisory Committee/Board Member, Consultant, Unrestricted educational grants. Celgene – Advisory Committee/Board Member, Consultant, Unrestricted educational grants. Eli Lilly – Advisory Committee/Board Member, Consultant. Genentech – Advisory Committee/Board Member, Consultant, Unrestricted educational grants. Gilead Sciences – Advisory Committee/Board Member, Consultant, Unrestricted educational grants. Janssen – Advisory Committee/Board Member, Consultant, Unrestricted educational grants. Miraca Labs – Advisory Committee/Board Member, Consultant. Pfizer Inc – Advisory Committee/Board Member, Consultant, Unrestricted educational grants. Prometheus – Advisory Committee/Board Member, Consultant. Salix – Advisory Committee/Board Member, Consultant. Seres – Advisory Committee/Board Member, Consultant. Takeda – Advisory Committee/Board Member, Consultant, Unrestricted educational grants. Target RWE – Advisory Committee/Board Member, Consultant. UCB – Advisory Committee/Board Member, Consultant, Unrestricted educational grants. Wolters Kluwer Health – Royalties.

Khaled Alsabbagh Alchirazi, MD¹, Aakash Desai, MD², Manasik Abdu, MD³, Thabet Qapaja, MD¹, Osama Hamid, MD, MRCPI¹, Alia Khamis, MD⁴, Miguel Regueiro, MD⁵. P0783 - Efficacy of Remdesivir for COVID-19 Infection in Patients With Inflammatory Bowel Disease: A Propensity-Matched Study, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.