Ursodeoxycholic acid and severe COVID-19 outcomes in a cohort study using the OpenSAFELY platform
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 chol...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Nature Research
2024
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| _version_ | 1826315485217554432 |
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| author | Costello, RE Waller, KMJ Smith, R Mells, GF Wong, AYS Schultze, A Mahalingasivam, V Herrett, E Zheng, B Lin, L MacKenna, B Mehrkar, A Bacon, SCJ Goldacre, B Tomlinson, LA Tazare, J Rentsch, CT |
| author_facet | Costello, RE Waller, KMJ Smith, R Mells, GF Wong, AYS Schultze, A Mahalingasivam, V Herrett, E Zheng, B Lin, L MacKenna, B Mehrkar, A Bacon, SCJ Goldacre, B Tomlinson, LA Tazare, J Rentsch, CT |
| author_sort | Costello, RE |
| collection | OXFORD |
| 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. |
| first_indexed | 2024-12-09T03:26:18Z |
| format | Journal article |
| id | oxford-uuid:5b6bb979-0cb8-4b20-a9cc-d0a42fa3210a |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-12-09T03:26:18Z |
| publishDate | 2024 |
| publisher | Nature Research |
| record_format | dspace |
| spelling | oxford-uuid:5b6bb979-0cb8-4b20-a9cc-d0a42fa3210a2024-11-28T20:03:44ZUrsodeoxycholic acid and severe COVID-19 outcomes in a cohort study using the OpenSAFELY platformJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:5b6bb979-0cb8-4b20-a9cc-d0a42fa3210aEnglishJisc Publications RouterNature Research2024Costello, REWaller, KMJSmith, RMells, GFWong, AYSSchultze, AMahalingasivam, VHerrett, EZheng, BLin, LMacKenna, BMehrkar, ABacon, SCJGoldacre, BTomlinson, LATazare, JRentsch, CTBackground: 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. |
| spellingShingle | Costello, RE Waller, KMJ Smith, R Mells, GF Wong, AYS Schultze, A Mahalingasivam, V Herrett, E Zheng, B Lin, L MacKenna, B Mehrkar, A Bacon, SCJ Goldacre, B Tomlinson, LA Tazare, J Rentsch, CT Ursodeoxycholic acid and severe COVID-19 outcomes in a cohort study using the OpenSAFELY platform |
| title | Ursodeoxycholic acid and severe COVID-19 outcomes in a cohort study using the OpenSAFELY platform |
| title_full | Ursodeoxycholic acid and severe COVID-19 outcomes in a cohort study using the OpenSAFELY platform |
| title_fullStr | Ursodeoxycholic acid and severe COVID-19 outcomes in a cohort study using the OpenSAFELY platform |
| title_full_unstemmed | Ursodeoxycholic acid and severe COVID-19 outcomes in a cohort study using the OpenSAFELY platform |
| title_short | Ursodeoxycholic acid and severe COVID-19 outcomes in a cohort study using the OpenSAFELY platform |
| title_sort | ursodeoxycholic acid and severe covid 19 outcomes in a cohort study using the opensafely platform |
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