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09-11-2020 | ACR 2020 | Conference coverage | News

COVID-19 cited as reason for making medication changes by patients with RA

Author: Lucy Piper


medwireNews: Patients with rheumatoid arthritis (RA) from the USA made substantial changes to their medication use during the first few months of the COVID-19 pandemic, research shows.

Kaleb Michaud (University of Nebraska Medical Center, Omaha, USA), presenting the data from FORWARD, The National Database for Rheumatic Diseases, commented that almost half of the changes to DMARD medications were made without physician guidance, particularly prior to the American College of Rheumatology (ACR) guidance becoming available in April 2020.

The results he reported at the ACR Convergence 2020 virtual meeting were based on COVID-19 web-based surveys completed by adults with RA in May/June 2020.

Through the months March to May, 30% of 734 respondents reported making changes to their medication, either decreasing the dose or discontinuing treatment, which Michaud commented was “a significantly larger number than there normally would have been in such a short period in general.”

Patients who made changes were significantly more likely to be taking glucocorticoids and less likely to be taking other medications, particularly non-hydroxychloroquine DMARDS, than those who did not change their treatment.

Taking glucocorticoids was a significant risk factor for treatment change, increasing the odds threefold. Other factors increasing this likelihood were worse disease activity, higher exposure to prior DMARDs, and fear of COVID-19.

Michaud noted that “many people changing their medications were just being worried about COVID-19.”

Indeed, this was the most frequently reported reason for making a change, at around 55%, and canceled and postponed appointments, often non-approved by the physician, were also a commonly cited reason, at around 25%.

The ACR issued guidelines addressing COVID-19 on April 13, 2020 and Michaud and team found that while the incidence of medication change was the same before and after this date, changes initiated by patients were twice as likely to happen before as afterwards, whereas physician-guided changes were more likely to occur after the guidance had been issued.

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2020 Springer Healthcare Ltd, part of the Springer Nature Group

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ACR Convergence virtual meeting; 5–9 November 2020