SpA Cases Flare Under COVID-19 Due to Misinformation

French researchers writing in Arthritis and Rheumatology report that of 609 surveyed spondyloarthritis patients self-isolating at home due to COVID-19, most say their condition has progressed while in isolation and for some, the change has been considerable.

The survey was led by Christian H. Roux, M.D., Ph.D., of Cote d’Azur University in Paris. Dr. Roux and colleagues surveyed spondyloarthritis (SpA) patients and of 609 respondents, 63 percent said their disease grew worse and 28 percent reported “considerable deterioration,” which patients attributed to changes in treatment. Since self-isolating at home, 49% of patients reporting having severe flares as compared to 20% prior to the start of self-isolation.

Of the 609 patients who responded to the survey, 43 percent said their treatment regimens changed since the start of the pandemic and then the flares set in. Why? The authors say it may have been largely due to misinformation spread by erroneous media reports on COVID-19.

The authors suggest that “inappropriate public warnings against the use of these drugs” may have led to confusion among doctors and patients about how best to proceed with ongoing treatments.

“The COVID-19 pandemic and the resulting confinement had significant consequences on our SpA population, with 43 percent of patients changing their treatment. The majority of treatment changes were observed in patients receiving NSAIDs regularly. This may be explained by the largely inappropriate public warnings against the use of these drugs and the consequent confusion among both the general population and medical community.

“To date, it remains unknown whether concomitant NSAIDs treatment is harmful or safe in patients with COVID-19. However, the American College guidelines recently endorsed the continued use of these agents. NSAIDs are the reference treatment for SpA, and it is interesting that the majority of the patients suspended this treatment without consulting their doctors, underlining the power of the media,” Dr. Roux and colleagues wrote.

Patients tended to discontinue NSAIDs when their condition worsened, and to a lesser degree, biologic DMARDs. Yet, no definitive causal link between flares and disruptions in treatment were made as other factors, such as the discontinuation of exercise and the stress of confinement, may have played a role.

REFERENCE

CH Roux, O Brocq, F Gerald, et al. "Impact of home confinement during the COVID-19 pandemic on medication use and disease activity in spondyloarthritis patients," Arthritis and Rheumatology. June 17, 2020.