160 | wileyonlinelibrary.com/journal/apt Aliment Pharmacol Ther. 2021;54:160–166. © 2021 John Wiley & Sons Ltd Received: 20 February 2021 | First decision: 22 March 2021 | Accepted: 3 May 2021 DOI: 10.1111/apt.16410 Risk of severe COVID-19 in patients treated with IBD medications: a French nationwide study Antoine Meyer 1,2,3 | Laura Semenzato 1 | Mahmoud Zureik 1,4 | Alain Weill 1 | Franck Carbonnel 2,3 | Rosemary Dray-Spira 1 The Handling Editor for this article was Professor Richard Gearry, and it was accepted for publication after full peer-review. 1 EPIPHARE, Épidémiologie des produits de santé, ANSM-CNAM, Saint Denis, France 2 Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin Bicêtre, France 3 Université Paris Saclay, Le Kremlin Bicêtre, France 4 Université Versailles Saint-Quentin en Yvelines, Montigny le Bretonneux, France Correspondence Antoine Meyer, 78 Rue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France. Email: antoinemeyer@gmail.com Summary Background: Recently, the SECURE-IBD study, based on a physician-reported regis- try, suggested that thiopurines, either alone or combined with anti-TNF, may increase risk of severe COVID-19. Aims: To compare the risk of severe COVID-19 according to IBD medications in a large and unselected population. Methods: Using the French national health data system, the risks of hospitalisation and of death or mechanical ventilation for COVID-19 from 15 February 2020 to 31 August 2020 in IBD patients were compared according to IBD treatment (im- munomodulators and biologics), using multivariable Cox models adjusted for socio- demographic characteristics, budesonide/corticosteroids and aminosalicylates use, and comorbidities. Results: Among 268 185 IBD patients, 600 were hospitalised for COVID-19 and 111 of them died or were mechanically ventilated (including 78 deaths). In multi- variable analysis, the risk of hospitalisation for COVID- 19 did not differ according to IBD treatment category, with adjusted Hazard Ratios (aHR, unexposed patients used as reference) of 0.94 (95%CI: 0.66-1.35) for immunomodulator monotherapy, 1.05 (0.80-1.38) for anti-TNF monotherapy, 0.80 (0.38- 1.69) for anti- TNF combina- tion therapy, 1.06 (0.55-2.05) for vedolizumab and 1.25 (0.64-2.43) for ustekinumab. Similarly, the risk of death or mechanical ventilation for COVID-19 did not differ ac- cording to IBD treatment. Conclusions: Immunomodulators and biologics prescribed in patients with IBD do not appear to increase the severity of COVID-19 infection. Funding information None.