COVID-19 UPDATE for patients with arthritis

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The recent COVID-19 (coronavirus) outbreak has caused significant concern amongst patients that are on immunosuppressive drugs for their arthritis. At Addenbrooke's Hospital, we are working hard to put together a guide for patients and this should be published on the Addenbrooke's Hospital Rheumatology page on 24/03/20.

Useful information can be found on the NHS website by following THIS link. For those currently on treatment, please note the advice below:

1. If well, it is not recommended that you stop treatment
2. If you are currently only on ONE of the following drugs: hydroxychloroquine, sulphasalazine and apremilast, you are unlikely to be at high risk 
3. You are advised to self-isolate and avoid face to face contact for a period of 3 months if you meet ANY ONE OF THE FOLLOWING CRITERIA:

• you are over 70 years of age
• you are on prednisolone 20mg or above
• you are on 2 or more conventional immunosuppressants (methotrexate, leflunomide, ciclosporin, cyclophosphamide, mycophenolate)
• you are on prednisolone (less than 20mg daily) and one of the above drugs
• you are on one or more of the above drugs AND a biologic drug (adalimumab, etanercept, infliximab, golimumab, certolizumab, rituximab, tocilizumab, abatacept, baricitinib, tofacitinib, secukinumab, ustekinumab, ixekizumab and other newer biologic drugs for your arthritis)
• you have 2 or more of the chronic medical conditions below (or 1 of these conditions and are on low dose steroids, or on a single immunosuppressant):

· Heart attack (myocardial infarction);

· Chronic heart failure;

· Hypertension (high blood pressure);

· Chronic lung diseases (e.g. asthma, COPD, bronchiectasis, fibrosis, interstitial lung disease, Bronchiolitis Obliterans, aspergillosis); 

· Peripheral vascular disease (blocked arteries in your limbs)

· Stroke (cerebrovascular accident/CVA) or TIA (transient ischaemic attack [‘mini-stroke’]);

· Dementia;

· Chronic liver disease (e.g. Primary Biliary Cirrhosis, Fibrosis, Cirrhosis [but not short-lived abnormalities of blood tests])

· Diabetes; 

· Chronic kidney disease – qualified as: ‘on, or being considered for, dialysis, or having had a kidney transplant);

· Recent cancer (i.e. you are still being cared for under the cancer team at the hospital and have not yet been told you ‘are cured’);

· HIV positive.