AB0899-HPR THE IMPACT OF CORONAVIRUS (COVID-19) PANDEMIC ON THERAPEUTIC MAINTENANCE IN PATIENTS WITH CHRONIC INFLAMMATORY RHEUMATIC DISEASES
Authors: T. El Joumani, H. Rkain, T. Fatima Zahrae, H. Kenza, A. Radouan, N. Laila, S. Bahloul, E. A. Nada, T. Latifa, N. Hajjaj-Hassouni, F. Allali
Journal: Annals of the Rheumatic Diseases (2021)

Background: The Coronavirus pandemic caused many consequences on well being, access to care and therapeutic maintenance in patients with chronic diseases. Objectives: To assess the impact of COVID-19 on therapeutic maintenance of patients with Chronic Inflammatory Rheumatic Diseases (CIRD) and to identify related factors to difficulties in access to rheumatologist care during the COVID-19 pandemic. Methods: A cross-sectional study was conducted among patients with rheumatic diseases using a questionnaire providing information on patients and disease characteristics, impact of COVID-19 on access to rheumatologist care and therapeutic maintenance during the confinement. Reasons of therapeutic interruption and of diificulties in access to healthcare were precised. Results: We received answers from 350 patients (female sex of 68%, mean age of 46,1 ± 14,4 years) suffering from Chronic Inflammatory Rheumatic Diseases (CIRD):rheumatic arthritis (RA) (62.3%), spondyloarthropathies (34.3%), and undifferentiated CIRD (3.4%). The global average disease evolution was 12,1 ± 9,7 years. The patients were treated with conventional Disease-modifying anti-rheumatic drugs (cDMARDs) and biologic Disease-modifying anti-rheumatic drugs (bDMARDs) in respectively 67.4% and 30.6% of cases. Corticosteroids and Nonsteroidal Anti-Inflammatories (NSAIDs) intake was noted in 39.1 and 33.7% of patients. Difficulties to access to rheumatologist care appointments were reported in 82.9% of the participants. Reasons of thoses difficulties are summurized in Figure 1. Figure 1. Causes of difficulties of access to Rheumatologist care during COVID-19 pandemic. Half of patients declared that the pandemic had affected their therapeutic compliance. Discontinued drugs were in decreasing order: Synthetic antimalarials (68.4%), NSAIDs (45.8%), Methotrexate (43.8%), bDMARDs (25.2%), Sulfasalazine (18.2%) and Corticosteroids (10,2%). Causes of treatments interruption are summarized in Table I. Table 1. Causes of treatments interuption in patients with CIRD Drugs Not found in pharmacies The pharmacy refuses to give me the treatment without a recent prescription To avoid the decrease in immunity and therefore to avoid catching Covid-19 I stopped the follow-up, and so I stopped the treatment... Other reasons NSAIDS 0 27.8 74.1 44.4 27.8 Corticosteroids 0 14.3 92.9 57.1 50 Methotrexate 70.1 3 10.4 16.4 22.4 Sulfasalazine 0 12.5 25 75 100 Synthetic antimalarial 69.2 0 0 23.1 61.5 Leflunomide 0 0 0 0 0 bDMARDs 0 7.4 40.7 44.4 51.9 Conclusion: The COVID-19 pandemic impacted heavly on therapeutic maintenance in CIRD patients in our country. Patients expressed many difficulties in access to appropiate management. Facing to all thoses consequences, we need to devolopp as soon as possible adequate solutions adapted in such health crisis, especially therapeutic education and telemedecine. Disclosure of Interests: None declared