Preferences of inflammatory arthritis patients for biological disease-modifying antirheumatic drugs in the first 100 days of the COVID-19 pandemic

Authors: UMUT KALYONCU, YAVUZ PEHLİVAN, SERVET AKAR, TİMUÇİN KAŞİFOĞLU, GEZMİŞ KİMYON, ÖMER KARADAĞ, HÜSEYİN EDİZ DALKILIÇ, ALİ İHSAN ERTENLİ, LEVENT KILIÇ, EMİNE DUYGU ERSÖZLÜ, CEMAL BES, HAKAN EMMUNGİL, RIDVAN MERCAN, ELİF EDİBOĞLU, NİLÜFER ALPAY KANITEZ, EMRE BİLGİN, SEDA ÇOLAK, SÜLEYMAN SERDAR KOCA, EMEL GÖNÜLLÜ, ORHAN KÜÇÜKŞAHİN, BELKIS NİHAN COŞKUN, BURCU YAĞIZ, SEDAT KİRAZ

Abstract: Background/aim: To evaluate treatment adherence and predictors of drug discontinuation among patients with inflammatory arthritis receiving bDMARDs within the first 100 days after the announcement of the COVID-19 pandemic. Materials and methods: A total of 1871 patients recorded in TReasure registry for whom advanced therapy was prescribed for rheumatoid arthritis (RA) or spondyloarthritis (SpA) within the 3 months (6-9 months for rituximab) before the declaration of COVID-19 pandemic were evaluated, and 1394 (74.5%) responded to the phone survey. Patients' data regarding demographic, clinical characteristics and disease activity before the pandemic were recorded. The patients were inquired about the diagnosis of COVID-19, the rate of continuation on bDMARDs, the reasons for treatment discontinuation, if any, and the current general disease activity (visual analog scale, [VAS]). Results: A total of 1394 patients (493 RA [47.3% on anti-TNF] patients and 901 SpA [90.0% on anti-TNF] patients) were included in the study. Overall, 2.8% of the patients had symptoms suggesting COVID-19, and 2 (0.15%) patients had PCR-confirmed COVID-19. Overall, 18.1% of all patients (13.8% of the RA and 20.5% of the SpA; p = 0.003) discontinued their bDMARDs. In the SpA group, the patients who discontinued bDMARDs were younger (40 [21-73] vs. 44 years [20-79]; p = 0.005) and had higher general disease activity; however, no difference was relevant for RA patients. Conclusion: Although the COVID-19 was quite uncommon in the first 100 days of the pandemic, nearly one-fifth of the patients discontinued bDMARDs within this period. The long-term effects of the pandemic should be monitored.

Keywords: COVID-19, biologic DMARDs, rheumatoid arthritis, spondyloarthritis

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