COVID-19 Clinical Guidance for Adult Patients with Rheumatic Diseases
(Part 3)
Let us continue our discussion on the treatment of rheumatic patients in the light of infections caused by the Coronavirus disease (Covid).
For the treatment of patients who are newly diagnosed or are having active rheumatic diseases, in the absence of infection or SARS-CoV-2 exposure, it is best to give these patients Hydroxychloroquine or chloroquine (HCQ/CQ). This disease-modifying anti-rheumatic drug (DMARD) should be continued, when available.
In patients who are well-controlled on an IL-6 inhibitor, this DMARD should be continued, when available.
The experts noted the uncertainty involving the use of Janus Kinase (JAK) inhibitors in these patients.
Moreover, the patients with moderate to high disease activity despite optimal use of DMARDs, may use biologics instead. Experts noted the uncertainty involving the use of JAK inhibitors.
In active or newly diagnosed inflammatory arthritis, conventional synthetic DMARDs can be a good treatment regimen. The doctor may also opt to use low-dose glucocorticoids or non-steroidal anti-inflammatory drug.
For patients with systemic inflammatory or vital organ-threatening disease such as lupus, high-dose glucocorticoids or immunosuppressants may be used for these kinds of patients.
Experts warn the use HCQ for non-indicated diseases should be avoided especially in the context of drug shortage during the pandemic.
Next week we will explain the possible treatment regimen for stable patients of rheumatic diseases who have been exposed to positive Covid patients.