Many people taking treatments to control Rheumatology conditions are asking for advice on whether to continue medications like Methotrexate, Azathioprine, Mycophenolate, Sulphasalazine, Hydroxychloroquine and Prednisolone.
Below, I have compiled information from Versus Arthritis, a patient support and education website which is updated regularly.
Should Rheumatology patients stop their medication as a precaution?
Some Rheumatology patients, particularly those on steroids and biologics, will be immunosuppressed and should therefore be considered ‘high risk’. All patients should however continue to take their medication unless directed otherwise by their Rheumatology team. If you are planning to start or switch to a new medication this may now need to be reviewed. Please remember patients on long term glucocorticoids (steroids, prednisolone) should not stop these abruptly.
If you are showing any symptoms and you think you might have coronavirus or you’ve been in close contact with someone who has it:
- Stay at home and avoid close contact with other people
- Do not go to a GP surgery, pharmacy or hospital
- Dial the NHS 111 coronavirus service to find out what to do next
What precautions should patients be advised to take?
Patients concerned about the risk of infection should be advised to take precautions as outlined by Public Health England. In addition, patients should ensure that their vaccinations, such as flu and pneumococcal, are up to date to reduce the risk of secondary infections.
Should patients who become infected with the Coronavirus cease their medication?
If patients develop symptoms of any infection, established practice should be followed and immunosuppressive therapy paused for the duration of the infection and until they feel well, in consultation with their rheumatology team. The expectation is for those on glucocorticoids (steroids, prednisolone) where treatment should not be stopped abruptly and advice should be sought from their treating team.
Should patients take anti-inflammatory (NSAID) tablets like Ibuprofen?
The latest advice from the Medical Director of NHS England is that there is no evidence that NSAIDs increase the chance of getting COVID-19 infection.
There are some suggestions that NSAIDs may increase the risk of lung complications from the infection or slow recovery. This is not proven.
Meanwhile patients who believe they may have COVID-19 infection should not start taking NSAIDs and should use Paracetamol instead.
However those currently on NSAIDs for other medical reasons (e.g. arthritis) should not stop them.