Department of Rheumatology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
J Infect Dev Ctries. 2023 Jul 27;17(7):944-952. doi: 10.3855/jidc.17470.
We aimed to investigate the effects of the coronavirus disease 2019 (COVID-19) pandemic on the course and treatment of patients with inflammatory rheumatic musculoskeletal disease (iRMD) using biologic or targeted synthetic disease modifying and rheumatic drugs (b/tsDMARDs).
The study was carried out in two stages: in the first stage we investigated the delay of b/tsDMARD treatment in the first 3 months of the pandemic; in the second stage, we investigated all patients who decided to continue treatment after interruption in the 12-month period.
A total of 521 patients were included in the study. The iRMD diagnosis was listed as spondyloarthritis (SpA) (54.3%), rheumatoid arthritis (RA) (25.7%), psoriatic arthritis (PsA) (8.4%), vasculitis (6.1%), and others (5.4%). Concurrent use of hydroxychloroquine (hazard ratio [HR] = 1.49), iv bDMARD use (HR = 1.34), and a history of discontinuation of drug in the first 3 months of the pandemic (HR = 1.19) were determined as factors that reduced 12-month drug retention rates. The use of glucocorticoid (HR = 3.81) and having a diagnosis of interstitial lung disease/chronic obstructive lung disease (HR = 4.96) were found to increase the risk of being infected by SARS coronavirus 2 (SARS-CoV-2).
It was shown that approximately 1/5 of iRMD patients using b/tsDMARDs delayed their treatment due to the fear of COVID-19 in the first three months of the pandemic process. However, with good communication with the patients, b/tsDMARD treatment was restarted and the 12-month drug retention status was quite high.
我们旨在研究 2019 年冠状病毒病（COVID-19）大流行对使用生物制剂或靶向合成疾病修正抗风湿药物（b/tsDMARDs）的炎症性风湿性肌肉骨骼疾病（iRMD）患者病程和治疗的影响。
该研究分两个阶段进行：第一阶段，我们研究了大流行前 3 个月 b/tsDMARD 治疗的延迟；第二阶段，我们调查了在 12 个月期间中断治疗后决定继续治疗的所有患者。
共纳入 521 例患者。iRMD 诊断为脊柱关节炎（SpA）（54.3%）、类风湿关节炎（RA）（25.7%）、银屑病关节炎（PsA）（8.4%）、血管炎（6.1%）和其他疾病（5.4%）。同时使用羟氯喹（HR=1.49）、静脉内 bDMARD 治疗（HR=1.34）和大流行前 3 个月内停药史（HR=1.19）被确定为降低 12 个月药物保留率的因素。使用糖皮质激素（HR=3.81）和患有间质性肺病/慢性阻塞性肺病（HR=4.96）与感染严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的风险增加相关。
研究表明，大约有 1/5使用 b/tsDMARDs 的 iRMD 患者由于在大流行前三个月对 COVID-19 的恐惧而延迟了治疗。然而，通过与患者进行良好的沟通，b/tsDMARD 治疗得以重新开始，12 个月的药物保留状态相当高。
