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Managing patients with rheumatic diseases during the COVID-19 pandemic: The French Society of Rheumatology answers to most frequently asked questions up to May 2020 - 26/09/20

Doi : 10.1016/j.jbspin.2020.05.006 
Christophe Richez a, René-Marc Flipo b, Francis Berenbaum c, Alain Cantagrel d, Pascal Claudepierre e, Françoise Debiais f, Philippe Dieudé g, Philippe Goupille h, Christian Roux i, Thierry Schaeverbeke a, Daniel Wendling j, Thao Pham k, Thierry Thomas l,
a Centre Hospitalier Universitaire de Bordeaux, FHU ACRONIM, place Amélie-Raba-Léon, 33076 Bordeaux, France 
b Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Lille, Hôpital Roger Salengro, rue du Professeur-Emile-Laine, 59037 Lille cedex, France 
c Service de Rhumatologie, Centre Hospitalier Universitaire Saint-Antoine, 184, rue du Faubourg-Saint-Antoine, 755571 Paris cedex 12, France 
d Service de Rhumatologie, Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9, France 
e Service de Rhumatologie, Centre Hospitalier Universitaire Henri Mondor, 51 avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France 
f Service de Rhumatologie, Centre Hospitalier Universitaire, 2, rue de la Milétrie, BP 577, 86021 Poitiers cedex, France 
g Service de Rhumatologie, Groupe Hospitalier Universitaire Bichat–Claude Bernard, 46, rue Henri-Huchard, 75018 Paris, France 
h Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Tours, Hôpital Trousseau, 37044 Tours cedex 9, France 
i Service de Rhumatologie, Centre Hospitalier Universitaire Cochin, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France 
j Service de Rhumatologie, Centre Hospitalier Universitaire Jean-Minjoz, 1, boulevard Fleming, 25030 Besançon cedex, France 
k Service de Rhumatologie, Centre Hospitalier Universitaire Sainte Marguerite, 270, boulevard de Sainte-Marguerite, 13274 Marseille cedex 9, France 
l Department of Rheumatology, Hôpital Nord, CHU Saint-Étienne, Inserm U1059, Université de Lyon-Université Jean-Monnet, Saint-Étienne, France 

Corresponding author.

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Highlights

The SFR selected the most critical questions Rheumatologists must contend in the management of their patients with rheumatic diseases during COVID-19 pandemic.
A group of 10 experts from SFR and CRI boards proposed responses based on the current knowledge of May 2020.
In most circumstances, there is no contraindication to the initiation or continuation of anti-inflammatory drugs as well as DMARDs.
If signs suggestive of infection (coronavirus or other) occur, treatments should be discontinued and resumed, if necessary, after 2 weeks without any symptoms.

El texto completo de este artículo está disponible en PDF.

Abstract

Background

Rheumatologists must contend with COVID-19 pandemic in the management of their patients and many questions have been raised on the use of both anti-inflammatory drugs and disease-modifying anti-rheumatic drugs (DMARD). The French Society of Rheumatology (SFR) selected the most critical ones to the daily practice of a rheumatologist and a group of 10 experts from SFR and Club Rheumatism and Inflammation (CRI) boards proposed responses based on the current knowledge of May 2020.

Methods

Following the availability of the first 18 questions and statements, 1400 individuals consulted the frequently asked questions between the March 31, 2020 and April 12, 2020. As a result, 16 additional questions were forwarded to the SFR, and answered by the board. An additional round of review by email and video conference was organized, which included updates of the previous statements. The scientific relevance of 5 of the questions led to their inclusion in this document. Each response received a final assessment on a scale of 0–10 with 0 meaning no agreement whatsoever and 10 being in complete agreement. The mean values of these votes for each question are presented as the levels of agreement (LoA) at the end of each response. This document was last updated on April 17, 2020.

Results

Based on current scientific literature already published, in most circumstances, there is no contraindication to the initiation or continuation of anti-inflammatory drugs as well as DMARDs. If signs suggestive of infection (coronavirus or other) occur, treatments should be discontinued and resumed, if necessary, after 2 weeks without any symptoms. Only, some signals suggest that people taking an immunosuppressive dose of corticosteroid therapy are at greater risk of developing severe COVID-19. Intra-articular injections of glucocorticoids are allowed when there is no reasonable therapeutic alternative, and providing that precautions to protect the patient and the practitioner from viral contamination are adopted, included appropriate information to the patient.

conclusions

Currently available data on managing patients with rheumatic diseases during the COVID-19 pandemic are reassuring and support continuing or initiating symptomatic as well as specific treatments of these diseases, the main target of their management remaining their appropriate control, even during this pandemic.

El texto completo de este artículo está disponible en PDF.

Keywords : COVID-19, Inflammatory rheumatic diseases, Treatment, Health system


Esquema

Results: answers to most asked questions

© 2020  Société française de rhumatologie. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 87 - N° 5

P. 431-437 - octobre 2020 Regresar al número
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