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Early signs of positive COVID-19 outcomes for people on some axial SpA (AS) medications

by Karl Gaffney

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At the beginning of lockdown there was a huge amount of confusion about who should be shielding or practicing enhanced social distancing. NASS and rheumatology helplines were inundated with calls from people who were anxious and confused having been given conflicting information and some who hadn’t been given any information at all.

Health professionals had to rely on the limited information we had surrounding COVID-19 at the time, which was based on theoretical considerations on how medications which lowered the immune system could increase the risk of developing COVID or developing a more severe form during the global pandemic. We wanted to be cautious and protect patients, therefore we recommended that patients on biologic medication and DMARDS such as methotrexate be as careful as possible in order to reduce their risk.

In order to answer some of these important questions, a Global Rheumatology Register was established to increase our knowledge and understanding of how COVID-19 affects people with rheumatic conditions and those taking immunosuppressing drugs.  This is a database whereby clinicians are invited to register details of patients with rheumatic conditions and have contracted COVID-19.

Over 600 patients from 40 different countries have been included in the study so far which shows that only people who were taking more than 10mg of steroids were at greater risk of being hospitalised for COVID-19. No other drugs increased the risk of hospitalisation and anti TNF appears to decrease the risk. This does not relate to the likelihood of contracting the virus, just the severity.

This should be regarded as early evidence and more research will need be undertaken to substantiate the findings.  People should continue to follow the advice given to them by their rheumatologist. However, these results are positive and reassuring. We hope they will allay some of the fears of people with axial SpA (AS).

You can read the full article here as well as a press release from EULAR here. Please do complete the patient version if you haven’t already done so and help us to build a true picture of how COVID-19 affects people with axial SpA (AS).

Professor Karl Gaffney

Consultant Rheumatologist, Norfolk and Norwich University Hospital

Chair, NASS Medical Advisory Board