COVID-19 UPDATE for patients with arthritis
Information for patients with autoimmune conditions on immunosuppressive therapy
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:
- If well, it is not recommended that you stop treatment
- If you are currently only on ONE of the following drugs: hydroxychloroquine, sulphasalazine and apremilast, you are unlikely to be at high risk
- 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.