How has the COVID-19 pandemic affected our rheumatology patients using biological/targeted DMARDs?

• Published in: Journal of infection in developing countries Vol. 17; no. 7; pp. 944 - 952
• Main Authors: Gulle, Semih, Erez, Yesim, Karakas, Ali, Yuce Inel, Tuba, Kocaer, Sinem Burcu, Demirci Yildirim, Tuba, Can, Gercek, Sari, Ismail, Birlik, Merih, Onen, Fatos
• Format: Journal Article
• Language: English
• Published: Italy Journal of Infection in Developing Countries 27-07-2023
• Subjects: Arthritis; Coronaviruses; COVID-19; Lung diseases; Pandemics; COVID-19; rheumatology; SARS-CoV-2; b/tsDMARD; biologic therapy; pandemic
• DOI: 10.3855/jidc.17470
• EISSN: 1972-2680
• ISSN: 1972-2680; 2036-6590

We aimed to investigate the effects of the coronavirus disease 2019 (COVID-19) pandemic on the course and treatment of patients with inflammatory rheumatic musculoskeletal disease (iRMD) using biologic or targeted synthetic disease modifying and rheumatic drugs (b/tsDMARDs).
The study was carried out in two stages: in the first stage we investigated the delay of b/tsDMARD treatment in the first 3 months of the pandemic; in the second stage, we investigated all patients who decided to continue treatment after interruption in the 12-month period.
A total of 521 patients were included in the study. The iRMD diagnosis was listed as spondyloarthritis (SpA) (54.3%), rheumatoid arthritis (RA) (25.7%), psoriatic arthritis (PsA) (8.4%), vasculitis (6.1%), and others (5.4%). Concurrent use of hydroxychloroquine (hazard ratio [HR] = 1.49), iv bDMARD use (HR = 1.34), and a history of discontinuation of drug in the first 3 months of the pandemic (HR = 1.19) were determined as factors that reduced 12-month drug retention rates. The use of glucocorticoid (HR = 3.81) and having a diagnosis of interstitial lung disease/chronic obstructive lung disease (HR = 4.96) were found to increase the risk of being infected by SARS coronavirus 2 (SARS-CoV-2).
It was shown that approximately 1/5 of iRMD patients using b/tsDMARDs delayed their treatment due to the fear of COVID-19 in the first three months of the pandemic process. However, with good communication with the patients, b/tsDMARD treatment was restarted and the 12-month drug retention status was quite high.