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07-07-2020 | Systemic lupus erythematosus | News

COVID-19: SLE patients, physicians report problems with hydroxychloroquine access

Author: Claire Barnard


medwireNews: Findings from two studies suggest that patients with systemic lupus erythematosus (SLE) across multiple countries have experienced issues with accessing hydroxychloroquine (HCQ) during the COVID-19 pandemic.

In the first, Arielle Mendel (McGill University Health Centre, Montreal, Quebec, Canada) and team sent a survey about availability of the drug to 42 physicians who were members of the Systemic Lupus Erythematosus International Collaborating Clinics group in May 2020.

Of the 31 respondents representing 13 countries from Europe, North America, and Asia, 55% reported either current (16%) or previous (39%) HCQ shortages. Around three-quarters of participants said that system-level measures were taken to facilitate access to the drug for SLE patients, including limiting prescribing capabilities to specific specialties or diagnoses, and restricting dispensed supply.

“Some restrictions may have inadvertently delayed HCQ access for patients with SLE, who had to wait for physicians to update diagnostic codes in medical records, confirm diagnoses with pharmacies or apply for waivers,” note the researchers.

Mendel and colleagues highlight some country-specific findings, with no access issues reported by respondents in Sweden, Denmark, Singapore, and South Korea. On the other hand, access issues led to patient and physician organizations advocating for “rapid resolution of HCQ shortages” in the UK, USA, and Canada.

“According to this survey, HCQ access issues for patients with SLE occurred in multiple countries and continents during the COVID-19 pandemic,” they write in a letter to the Annals of the Rheumatic Diseases.

And the authors conclude: “Because SLE can flare as little as 2 weeks after HCQ cessation, further study of outcomes among patients who lost access to HCQ during the pandemic is warranted.”

The second study, published as a correspondence article in the same journal, evaluated SLE patients’ experience of HCQ access in Germany during the COVID-19 pandemic.

Among 369 respondents with complete results, 47.4% reported taking a daily HCQ dose of 200 mg, with approximately two-thirds having an HCQ treatment duration of at least 6 years.

Peter Korsten (University Medical Center Göttingen, Germany) and co-researchers report that the majority (95.8%) of patients “considered HCQ essential for their SLE treatment.” A total of 70.0% said they had concerns about accessing the drug, and 8.8% lowered their daily dose in anticipation of supply issues.

In all, 46% of respondents described various HCQ supply issues – including receiving a different product (17%), having to source the drug from a different pharmacy (14%), and not being able to obtain HCQ at all (6%) – whereas 44% said there were no issues with accessing the drug.

These findings “represent the first surveyed report in patients with SLE regarding HCQ supplies during the COVID-19 pandemic,” and suggest that they “are facing challenges with the improper use of essential drugs,” write Korsten and team.

“Ultimately, even during global crises, vulnerable populations need to be protected,” they conclude.

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

7 July 2020: The coronavirus pandemic is affecting all healthcare professionals across the globe. Medicine Matters’ focus, in this difficult time, is the dissemination of the latest data to support you in your research and clinical practice, based on the scientific literature. We will update the information we provide on the site, as the data are published. However, please refer to your own professional and governmental guidelines for the latest guidance in your own country.

Ann Rheum Dis 2020; doi:10.1136/annrheumdis-2020-218164
Ann Rheum Dis 2020; doi: 10.1136/annrheumdis-2020-217967