Inflammatory arthritis disease activity unaffected by reduced in-patient appointments
medwireNews: Fewer in-person interactions between inflammatory arthritis patients and their rheumatologists during the COVID-19 pandemic wave in Switzerland may have led to reduced drug adherence, but patients’ disease activity has remained stable, an analysis of patient-reported outcomes reveals.
Adrian Ciurea (University Hospital Zurich, Switzerland) and colleagues studied data pertaining to 666 individuals with axial spondyloarthritis (axSpA), rheumatoid arthritis (RA), or psoriatic arthritis (PsA) from the Swiss Clinical Quality Management Cohort.
Between March and April 2020, during the first COVID-19 pandemic wave, the number of in-patient appointments with rheumatologists dropped by 52% compared with the preceding 2 months. During this same timeframe, the number of remote web-based assessments rose by 129%.
During this time, the rate of DMARD medication nonadherence rose in all three patient groups compared with pre-COVID-19 rates. This increase was significant among the axSpA patients, with rates of 19.9% versus 13.2%, respectively, but not among those with RA (22.2 vs 14.9%) or PsA (19.1 vs 14.5%).
Nonetheless, Ciurea et al say that the disease activity of the patients was “stable” for the first 6 months of 2020, while noting that there was a slight increase during March and April when compared with January and February, which reached statistical significance only among the axSpA patients, at mean BASDAI scores of 3.23 and 3.40 points, respectively.
Among the RA patients, scores on the Rheumatoid Arthritis Disease Activity Index-5 dropped from an average 2.46 to 2.39 points, while Patient Global Assessment scores fell from an average 3.43 to 3.30 points among those with PsA.
There was also no significant difference in the proportion of patients who experienced disease flares in the 2 months prior to the COVID-19 wave, compared with during or after the wave, with corresponding rates of 2.4%, 2.4%, and 4.2% for axSpA patients, 11.0%, 10.9%, and 13.3% for RA patients, and 9.8%, 14.5%, and 16.0% for PsA patients.
Ciurea and fellow researchers therefore conclude in the Annals of the Rheumatic Diseases: “A short interruption of in-person patient-rheumatologist interactions had no major detrimental impact on the disease course of axSpA, RA, and PSA as assessed by patient-reported outcomes.”
And they continue that this “informs potential future measures of public lockdown,” while emphasizing that “[a]s patient-reported outcomes are insufficient to guide treat-to-target efforts, assessments of long-term outcomes are warranted.”
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2020 Springer Healthcare Ltd, part of the Springer Nature Group
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