Healthcare Visits, DMARD Treatment Both Interrupted for Autoimmune Rheumatic Patients During COVID-19

The COVID-19 pandemic impacted virtually all areas of health care, whether it be access to medication, conversions to telemedicine, or a number of other changes. Patients with autoimmune rheumatic diseases have been of particular concern among healthcare providers due to concerns over the worsened effects associated with catching COVID-19 as well as unauthorized delays in treatment. According to a study, during the early days of the pandemic, patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), and systemic lupus erythematosus (SLE) often avoided office visits and frequently experienced disease-modifying antirheumatic drug (DMARD) interruptions.

Adult patients with RA, PsA, AS, and SLE who were identified from the ArthritisPower Patient-Powered Research Network and CreakyJoints patient community were invited to fill out a survey about their concerns and behaviors during the COVID-19 pandemic. Comparisons were made by different autoimmune conditions, DMARD use, and geographic measures of urban status, income, education, and COVID-19 activity.

A total of 1,517 patients filled out the survey (RA, n=925; PsA, n=299; AS, n=185; and SLE, n=108). The mean age was 55.1 years, and most patients were female (88.3%) and White (89.5%). Geographic location did not significantly impact COVID-19 concerns. Patients taking biologics had more concerns about the pandemic (P<0.001). Patients reported avoiding doctor’s office visits (56.6%), avoiding laboratory testing (42.3%), and using telemedicine (29.5%), all of which was more common in urban locations. Of the patients taking DMARDs who did not have COVID-19 or other respiratory illness, 14.9% stopped a DMARD; nearly all treatment interruptions (78.7%) were not recommended by their physician. Patients with lower socioeconomic status were more likely to stop DMARDs, as were patients who avoided an office visit (odds ratio [OR], 1.46) or reported lack of telemedicine availability (OR, 2.26).

The study was published in The Journal of Rheumatology.

“In the early months of the COVID-19 pandemic, patients with RA, PsA, AS, and SLE frequently avoided office visits and laboratory testing. DMARD interruptions commonly occurred without the advice of a physician and were associated with socioeconomic status, office visits, and telehealth availability, highlighting the need for adequate healthcare access and attention to vulnerable populations during the pandemic,” the study authors concluded.