ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: L05

DMARD Changes for Patients with Rheumatoid Arthritis in the US During the First Three Months of the COVID-19 Pandemic

Kaleb Michaud1, Sofia Pedro2, Kristin Wipfler3, Ekta Agarwal4 and Patricia Katz5, 1University of Nebraska Medical Center and Forward, the National Databank for Rheumatic Diseases, Omaha, NE, 2Forward, The National Databank for Rheumatic Diseases, Wichita, KS, 3FORWARD, The National Databank for Rheumatic Diseases, Omaha, NE, 4Pfizer inc, Princeton Jct, NJ, 5UCSF, Mill Valley, CA

Meeting: ACR Convergence 2020

Date of first publication: October 23, 2020

Keywords: Access to care, COVID-19, Disease-Modifying Antirheumatic Drugs (Dmards), Late-Breaking 2020

  • Tweet
  • Email
  • Print
Session Information

Date: Monday, November 9, 2020

Session Title: Late-Breaking Posters

Session Type: Poster Session D

Session Time: 9:00AM-11:00AM

Background/Purpose: To understand medication and clinical care changes by patients with RA during the first 3 months (March through May 2020) of the COVID-19 pandemic in the US.

Methods: Data were provided by adults with RA participating in the FORWARD observational registry who answered COVID-19 web-based surveys in May/June 2020 and who previously provided baseline characteristics and medication use for 2019. We compared medication changes by pre-COVID DMARD exposure in logistic models first without adjustment and then adjusting for age, sex, comorbidities including pulmonary and cardiovascular diseases, education, health insurance, RA activity (PAS-II), fatigue, and polysymptomatic distress (PSD). We also examined rates of medication change before and after the first COVID-19 ACR treatment guidelines in April.

Results: Of the 734 respondents, 221 (30%) reported medication changes. Changers were more likely to use glucocorticoids (GCs, 33% vs 18%) and less likely to use non-hydroxychloroquine (HCQ) csDMARDs (49% vs 62%) pre-COVID. While JAKi use was associated (OR 1.9 [95% CI 1.0, 3.4]) with change in bivariate analyses, only GCs remained as a strong factor (OR 3.0 [1.9, 4.9]) in multivariable models. Change in care was most associated with pulmonary disease (OR 2.9 [1.3, 6.5]) and GC use (OR 1.6 [1.0, 2.5]). While the incidence of medication change before and after April 15 was the same, patient-initiated changes due to COVID-19 were twice as likely before April 15, and physician-guided changes were more likely after.

Conclusion: Our findings confirm US patients with RA made substantial changes to their medication use during the first 3 months of the COVID-19 pandemic. Almost half of DMARD decrease or discontinuations were made without physician guidance, and all types of medication changes after ACR recommendations were made with increased physician guidance. While no direct causation was measured, our findings provide evidence of possible implementation of these recommendations.

Mean (SD) baseline characteristics of RA patients who changed their medications vs. those who did not.

Kaplan-Meier time to medication change by reason for change and physician approval status before and after April 15, 2020, ACR guidelines


Disclosure: K. Michaud, None; S. Pedro, None; K. Wipfler, None; E. Agarwal, Pfizer, 3; P. Katz, None.

To cite this abstract in AMA style:

Michaud K, Pedro S, Wipfler K, Agarwal E, Katz P. DMARD Changes for Patients with Rheumatoid Arthritis in the US During the First Three Months of the COVID-19 Pandemic [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/dmard-changes-for-patients-with-rheumatoid-arthritis-in-the-us-during-the-first-three-months-of-the-covid-19-pandemic/. Accessed January 30, 2023.
  • Tweet
  • Email
  • Print

« Back to ACR Convergence 2020

ACR Meeting Abstracts - https://acrabstracts.org/abstract/dmard-changes-for-patients-with-rheumatoid-arthritis-in-the-us-during-the-first-three-months-of-the-covid-19-pandemic/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2023 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences