Medication Interruptions and Subsequent Disease Flares During the COVID-19 Pandemic: A Longitudinal Online Study of Patients With Rheumatic Disease

被引：16

作者：

Dharia, Tiffany ^{[1
]}

Venkatachalam, Shilpa ^{[2
]}

Baker, Joshua F. ^{[1
]}

Banerjee, Shubhasree ^{[1
]}

Curtis, David ^{[2
]}

Danila, Maria I. ^{[3
]}

Gavigan, Kelly ^{[2
]}

Gordon, Jennifer ^{[4
]}

Merkel, Peter A. ^{[1
]}

Shaw, Dianne G. ^{[5
]}

Young, Kalen ^{[5
]}

Curtis, Jeffrey R. ^{[3
]}

Nowell, William B. ^{[2
]}

George, Michael D. ^{[1
]}

机构：

[1] Univ Penn, Philadelphia, PA 19104 USA

[2] Global Hlth Liv Fdn, Upper Nyack, New York, NY USA

[3] Univ Alabama Birmingham, Birmingham, AL USA

[4] Temple Univ, Philadelphia, PA 19122 USA

[5] Vasculitis Fdn, Kansas City, MO USA

来源：

ARTHRITIS CARE & RESEARCH | 2022年 / 74卷 / 05期

关键词：

PSORIATIC-ARTHRITIS; RISK;

D O I：

10.1002/acr.24837

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective We aimed to assess trends in anxiety and interruptions in disease-modifying antirheumatic drug (DMARD) use among patients with rheumatic diseases during the COVID-19 pandemic and to evaluate whether DMARD interruptions were associated with disease flares. Methods ArthritisPower, the Vasculitis Patient-Powered Research Network, and other patient organizations invited members to join a 52-week longitudinal study, with baseline surveys completed March 29 to June 30, 2020, with follow-up through May 2021. Logistic regression incorporating generalized estimating equations evaluated associations between interruptions in DMARD use and self-reported disease flares at the next survey, adjusting for demographic characteristics, medications, disease, and calendar time. Results Among 2,424 patients completing a median of 5 follow-up surveys, the mean age was 57 years, 87% were female, and the most common conditions were rheumatoid arthritis, vasculitis, and psoriatic arthritis. Average Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety T scores decreased from April 2020 (58.7) to May 2021 (53.7) (P < 0.001 for trend). Interruptions in DMARD use decreased from April (11.2%) to December 2020 (7.5%) (P < 0.001) but increased through May 2021 (14.0%) (P < 0.001). Interruptions in DMARD use were associated with a significant increase in severe flares (rated >= 6 of 10) at the next survey (12.9% versus 8.0% [odds ratio (OR) 1.71 (95% confidence interval [95% CI 1.23, 2.36]) although not any flare (OR 1.18 [95% CI 0.89, 1.58])]. Conclusion Anxiety and interruptions in DMARD use initially decreased over time, but DMARD interruptions increased during 2021, possibly related to an increase in COVID-19 cases or vaccine availability. Interruptions in DMARD use were associated with increased rates of severe disease flares, highlighting the importance of avoiding unnecessary DMARD interruptions.

引用

页码：733 / 740

页数：8

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