Preferences of inflammatory arthritis patients for biological disease-modifying antirheumatic drugs in the first 100 days of the COVID-19 pandemic

Abstract

Background/aim To evaluate treatment adherence and predictors of drug discontinuation among patients with inflammatory arthritis receiving bDMARDs within the first 100 days after the announcement of the COVID-19 pandemic. Materials and methods A total of 1871 patients recorded in TReasure registry for whom advanced therapy was prescribed for rheumatoid arthritis (RA) or spondyloarthritis (SpA) within the 3 months (6–9 months for rituximab) before the declaration of COVID-19 pandemic were evaluated, and 1394 (74.5%) responded to the phone survey. Patients’ data regarding demographic, clinical characteristics and disease activity before the pandemic were recorded. The patients were inquired about the diagnosis of COVID-19, the rate of continuation on bDMARDs, the reasons for treatment discontinuation, if any, and the current general disease activity (visual analog scale, [VAS]). Results A total of 1394 patients (493 RA [47.3% on anti-TNF] patients and 901 SpA [90.0% on anti-TNF] patients) were included in the study. Overall, 2.8% of the patients had symptoms suggesting COVID-19, and 2 (0.15%) patients had PCR-confirmed COVID-19. Overall, 18.1% of all patients (13.8% of the RA and 20.5% of the SpA; p = 0.003) discontinued their bDMARDs. In the SpA group, the patients who discontinued bDMARDs were younger (40 [21–73] vs. 44 years [20–79]; p = 0.005) and had higher general disease activity; however, no difference was relevant for RA patients. Conclusion Although the COVID-19 was quite uncommon in the first 100 days of the pandemic, nearly one-fifth of the patients discontinued bDMARDs within this period. The long-term effects of the pandemic should be monitored.

Impact of the First SARS-CoV-2 Lockdown on Adherence to Biological Treatment in Patients with Immune-Mediated Inflammatory Diseases in the Netherlands

“…The main reason for discontinuation was fear of the side effects of biological treatment. 14 This reason is in line with our (abovementioned) hypothesis of non-adherent behavior during the first SARS-CoV-2 lockdown.…”

“…Expected discordant proportions were based on the results of a previous study and expert opinion. 14 Characteristics of the study population and adherence measurements were described with means, standard deviations, medians, interquartile ranges, and percentages as appropriate. The internal reliability of the MARS-5 was calculated using Cronbach’s α.…”

Attitudes of patients with a rheumatic disease on drug use in the COVID-19 pandemic

“…Another Latin American study revealed that 90% (n = 293) of patients did not modify their drug schedule [16]. In various studies conducted in Italy, America, Spain and Turkey, it was reported that approximately 75-80% of patients did not change their treatment [20][21][22][23].…”

Influence of the COVID-19 Pandemic on Medical Management and on Healthcare Delivery of Immune-Mediated Rheumatic and Musculoskeletal Diseases during the First Pandemic Period February to July 2020: A Systematic Review

“…Seventeen studies were from Europe [15,16,18,19,21,22,24,[28][29][30][31]37,39,41,42,46,47], three from Africa [14,17,34], ten from North America [23,[25][26][27]33,35,36,38,45,48,49] and five from Asia [20,32,40,43,44]. Details of the included studies are shown in Table 1.…”

“…The drugs mostly changed or stopped were bDMARDs and JAKi [28,32]. Low-dose prednisolone and csDMARDs were the least likely medications to be stopped.…”