Background/Purpose: Adherence to treatments for chronic rheumatic diseases is influenced by many factors, including the patient’s belief in the development of adverse effects such as increased susceptibility to infection. It seems logical to think that immunosuppressive therapy increases the risk of severe affectation if SARS-CoV2 infection occurs and that many patients may tend to stop their biological treatment, especially in areas with a high incidence of COVID-19

The OBJECTIVE is to determinate the adherence in patients with rheumatic diseases treated with biological therapies during COVID-19 health crisis period in Madrid.

Methods: Prospective observational study. Telephone interviews were conducted between April 22 and May 15, 2020 (either by the rheumatologist or the hospital pharmacist) in patients with rheumatic diseases such us rheumatoid arthritis (RA), spondyloarthritis (SpA) and psoriatic arthritis (PsA) treated with any subcutaneus biological (bDMARD) or targeted synthetic disease-modifying antirheumatic drug (tsDMARD)

Patients were asked about continuation or discontinuation of any medication received for their chronic rheumatic disease, possible reasons that led to drug discontinuation (including fear of immunosuppresion and lack of resources/drug shortage), whether advise was received from a clinician or other sources. We also asked if they knew by the media channels that treatments for rheumatic diseases were being used in severe forms of COVID-19 infection. Patients were considered non-adherent if they had missed or delayed any of the prescribed doses. All patients received the medication through a home delivery system.

Results: We telephone-interviewed 400 patients followed-up in our centre (196 RA, 115 PsA and 89 SpA) during confinement period due to the coronavirus pandemic. 32 (8%) patients discontinued their treatment, 14 of them (43.75%) due to the fear of suffering the infection, 9 (28.12%) due to COVID-19 infection symptomatology , 4 (12.5%) for some reasons not related to COVID-19, 3 (9.38%) due to lack of resources/shortage of drug and 2 (6.25%) due to confirmed COVID-19 infection. 222 patients (58.57%) knew about the use of anti-rheumatic drugs for the treatment of COVID-19 infection.

Conclusion: Adherence to treatment for rheumatic diseases during the COVID-19 health crisis period was very high in Madrid, despite of being one of the cities hardest hit by the SARS-CoV-2.

A high Knowledge of the use of anti-rheumatic drugs for the treatment of COVID-19 on the media channels and the better access to treatments through a home delivery system has contributed to this adherence.

The main reasons that led to drug discontinuation was the fear of suffering the infection or for having COVID-19 infection symptomatology.

Although the presence of COVID-19 infection was not the reason for the survey, we only found 2 patients diagnosed of COVID-19 with positive PCR test for SARS-CoV-2, and 9 posible patients, due to the symptoms they reffered, among our 400 patients. However, these findings point in the direction that COVID-19 course and mortality in patients with chronic rheumatic diseases treated with b/tsDMARD do not differ from the general population. Doubtlessness, additional studies are still needed.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/adherence-in-patients-with-chronic-rheumatic-diseases-treated-with-biological-and-synthetic-targeted-therapies-during-covid-19-pandemic/