ACR: Patients can restart rheumatic treatments 7-14 days after COVID-19 symptoms resolve
Patients with uncomplicated COVID-19 infections may consider restarting rheumatic disease treatments within 7 to 14 days of symptom resolution, according to updated guidelines from the American College of Rheumatology.
On July 23, the ACR issued two additions to its previously released “COVID-19 Clinical Guidance for Adult Patients with Rheumatic Diseases.” The updates focus on treatment after COVID-19 infection.
“When the ACR first prepared its ‘COVID-19 Clinical Guidance for Adult Patients with Rheumatic Diseases,’ we envisioned that this would be a living document that would be continuously updated as new data became available during the SARS-CoV-2 pandemic,” Ellen M. Gravallese, MD, president of the ACR, told Healio Rheumatology.
“There have been many questions from rheumatologists regarding the timing of reinitiation of rheumatic disease therapies after their discontinuation during COVID-19 infection or in asymptomatic individuals after a positive COVID-19 test,” she added. “Since new data has been published in this area, the task force made the decision to proceed with its first revision of the guidance document.”
The ACR’s updates include:
- Patients with uncomplicated COVID-19 cases, characterized by mild or no pneumonia, and treated in an ambulatory setting or through self-quarantine, may consider restarting rheumatic treatments, such as DMARDs, immunosuppressants, biologics and JAK inhibitors, within 7-14 days of symptom resolution;
- For patients who test positive for COVID-19 but are — and remain — asymptomatic, providers may consider restarting rheumatic treatments 10-17 days following the positive result; and
- Decisions regarding the timing of resuming rheumatic therapies in patients who are recovering from more severe cases of COVID-19 should be made on a case-by-case basis.
These updates were approved by the ACR’s COVID-19 Clinical Guidance Task Force with a “high” level of consensus.
The “COVID-19 Clinical Guidance for Patients with Rheumatic Diseases” was initially released in April.
The full list of guidance statements can be found here.
“The new recommendations should offer providers some guidance as they continue to focus on controlling inflammation in patients with rheumatic diseases during the COVID-19 pandemic,” Gravallese said. “In patients for whom therapies have had to be held for documented infection or for a positive test for COVID-19, guidance for reinitiation of therapy was felt by the task force to be a high priority.”