| Title: |
Ursodeoxycholic acid and severe COVID-19 outcomes in a cohort study using the OpenSAFELY platform. |
| Authors: |
Costello, Ruth E; Waller, Karen MJ; Smith, Rachel; Mells, George F; Wong, Angel YS; Schultze, Anna; Mahalingasivam, Viyaasan; Herrett, Emily; Zheng, Bang; Lin, Liang-Yu; MacKenna, Brian; Mehrkar, Amir; Bacon, Sebastian CJ; Goldacre, Ben; Tomlinson, Laurie A; Tazare, John; Rentsch, Christopher T; OpenSAFELY collaborative; LH&W NCS (or CONVALESCENCE) Collaborative |
| Publisher Information: |
Springer Science and Business Media LLC |
| Publication Year: |
2024 |
| Collection: |
London School of Hygiene & Tropical Medicine: LSHTM Research Online |
| Description: |
BACKGROUND: Biological evidence suggests ursodeoxycholic acid (UDCA)-a common treatment of cholestatic liver disease-may prevent severe COVID-19 outcomes. We aimed to compare the hazard of COVID-19 hospitalisation or death between UDCA users versus non-users in a population with primary biliary cholangitis (PBC) or primary sclerosing cholangitis (PSC). METHODS: With the approval of NHS England, we conducted a population-based cohort study using primary care records between 1 March 2020 and 31 December 2022, linked to death registration data and hospital records through the OpenSAFELY-TPP platform. Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between time-varying UDCA exposure and COVID-19 related hospitalisation or death, stratified by geographical region and considering models unadjusted and fully adjusted for pre-specified confounders. RESULTS: We identify 11,305 eligible individuals, 640 were hospitalised or died with COVID-19 during follow-up, 400 (63%) events among UDCA users. After confounder adjustment, UDCA is associated with a 21% relative reduction in the hazard of COVID-19 hospitalisation or death (HR 0.79, 95% CI 0.67-0.93), consistent with an absolute risk reduction of 1.35% (95% CI 1.07%-1.69%). CONCLUSIONS: We found evidence that UDCA is associated with a lower hazard of COVID-19 related hospitalisation and death, support calls for clinical trials investigating UDCA as a preventative measure for severe COVID-19 outcomes. |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| ISSN: |
2730-664X |
| Relation: |
https://researchonline.lshtm.ac.uk/id/eprint/4679377/1/Costello-etal-2024-Usodeoxycholic-acid-and-severe.pdf; Costello, Ruth E ORCID logo; Waller, Karen MJ; Smith, Rachel; Mells, George F; Wong, Angel YS ORCID logo; Schultze, Anna ORCID logo; Mahalingasivam, Viyaasan ORCID logo; Herrett, Emily ORCID logo; Zheng, Bang; Lin, Liang-Yu; +9 more.MacKenna, Brian; Mehrkar, AmirORCID logo; Bacon, Sebastian CJ; Goldacre, Ben; Tomlinson, Laurie A ORCID logo; Tazare, John ORCID logo; Rentsch, Christopher T ORCID logo; OpenSAFELY collaborative; and LH&W NCS (or CONVALESCENCE) Collaborative (2024) Ursodeoxycholic acid and severe COVID-19 outcomes in a cohort study using the OpenSAFELY platform. Communications medicine, 4. p. 238. ISSN 2730-664X DOI:10.1038/s43856-024-00664-y |
| DOI: |
10.1038/s43856-024-00664-y |
| Availability: |
https://researchonline.lshtm.ac.uk/id/eprint/4679377/; https://doi.org/10.1038/s43856-024-00664-y |
| Rights: |
cc_by_4 |
| Accession Number: |
edsbas.E7A64103 |
| Database: |
BASE |