Patients with rheumatoid arthritis living through the current COVID-19 pandemic face some unique challenges when it comes to their disease and its treatment. Here are the answers to three frequently asked questions for patients who have rheumatoid arthritis.
1. How do I ensure continued access to my medications?
The drug hydroxychloroquine or Plaquenil was originally developed for malaria but is also used for treating conditions like rheumatoid arthritis and lupus. Despite media reports, there is currently no conclusive medical evidence to support its use as an antiviral or COVID treatment, however clinical trials are ongoing to address this question. Unfortunately, this publicity has led to shortages of hydroxychloroquine for rheumatology patients who do benefit from this medication.
The Food and Drug Administration (FDA) recently stated that it is working with drug manufacturers to improve the supply of hydroxychloroquine. In the meantime, here are some steps that you can take to ensure you have access to the medications you need:
- Call your rheumatologist for a refill before you run out.
- Ask for a 90-day supply instead of 30 days.
- Request your doctor indicate your diagnosis on the prescription, some pharmacies will prioritize prescriptions for patients with a rheumatoid arthritis diagnosis.
- Remember that the beneficial effects of hydroxychloroquine can persist for up to three months after your last dose, so even if you miss a few days of treatment it is unlikely to result in long term harm.
2. Immunosuppressants – to taken them, or not to take them?
You may be wondering whether to stop your immunosuppressive medications. This includes drugs like methotrexate and injectable biologics taken by many patients with rheumatoid arthritis. These drugs lower your immunity and can predispose you to infections.
The answer here isn’t so cut and dry. It is very important that you discuss treatment options with your rheumatologist. Each patient is unique, however most experts advise continued immunosuppressive therapy for rheumatoid arthritis unless there is an actual infection. By stopping treatment preventively, you can increase your risk of an arthritis flare, pain, joint damage and disability.
3. How can I protect myself from getting COVID-19?
By now the preventive steps are well known. It really comes down to the basics of infection prevention. Nothing beats regular hand washing, wear a mask when out in public places and maintain social distancing by staying six feet away from others. For rheumatology patients, it is especially important to be up to date on your vaccines. Make sure you get a flu shot this upcoming flu season and ask your doctor if you should have the pneumonia and shingles vaccines as those depend on your age and medication profile
It is also important to note that telemedicine services are now widely offered. It’s easier than ever to stay in touch with your healthcare providers. Don’t put your health on hold. Take care of yourself.
Aitezaz Ahmed, MD is a Rheumatologist at Mather Rheumatology. Mather Rheumatology is a practice of Harbor View Medical Services, PC, which is wholly owned by Mather Hospital.