Background: Prescribing biologic disease-modifying antirheumatic drugs (bDMARDs) and Janus kinase (JAK) inhibitors during the global pandemic of coronavirus disease 2019 (COVID-19) requires a balanced approach and rigorous monitoring of patients’ condition.
Objectives: To evaluate the effect of bDMARDs and JAK inhibitors on the condition of patients with rheumatoid arthritis (RA), taking into account the outcomes assessed by the patients themselves, as well as the incidence of COVID-19 in these patients.
Methods: A telephone survey was conducted of 254 patients with RA (age 49.8 ± 13.7 years, 83.5% women, RF + 64.4%, DAS28 5.4 ± 1.6), who in the period from January 2020 to June 2021 by decision of the medical commission of the V.A. Nasonova Research institute was first prescribed bDMARDs or JAK inhibitors: rituximab (RTX) - 148 (58.3%), TNF-a inhibitors - 57 (22.4%), JAK inhibitors - 20 (7.9%), IL 6 inhibitors - 17 (6 .7%), abatacept - 12 (4.7%).
Results: At the time of the survey, 204 (80.3%) patients continued to take the prescribed drugs. The main cause discontinuation of treatment was for non-medical reasons. Synthetic DMARDs (mainly methotrexate and leflunomide) were received by 68.0%, glucocorticoids - 45.3%, non-steroidal anti-inflammatory drugs - 44.5% of respondents. Among the patients who took bDMARDs or JAK inhibitors, 68.1% noted the “state of symptoms acceptable to the patient”, the absence of frequent joint pain - 65.3%, increased fatigue - 14.3%. The incidence of COVID-19 and hospitalization associated with this disease didn’t differ between individuals who continued and discontinued the use of bDMARDs or JAK inhibitors: 41.2% and 44.6; 13.7% and 14.0% respectively, p=0.80884. There was no significant difference in the incidence of COVID-19 and hospitalization associated with this disease in patients taking various biologics or JAK inhibitors.
Conclusion: Despite the COVID-19 pandemic, rituximab remains one of the most popular bDMARD. About a third of patients receiving bDMARDs and JAK inhibitors aren’t satisfied with their condition. More than 40% of patients treated with these drugs experienced COVID-19, and 14.0% required hospitalization.
Disclosure of Interests: None declared