AB0711\u2005FOLLOW-UP OF PATIENTS UNDER BIOLOGICS IN THE ERA OF LOCKDOWN

Abstract

Background: The management of patients with inflammatory rheumatic diseases under biologics has raised many questions about the global management of patients in the time of COVID-19 pandemic. This period could have been particularly painful for the patients due to the virus itself, and to the difficulty to access to healthcare facilities due to the lockdown. Objectives: To assess the impact of the lockdown in patients under biologics. Methods: This is a descriptive study, conducted between 03/01/2021 and 07/31/2021 in the Department of Rheumatology of the University Hospital of Ibn Rochd in Casablanca. Inclusion criteria were all patients on biologics during the lockdown period. The number of painful, swollen joints, pain visual analogue scale, and disease activity were collected before and during the lockdown. Results: Thirty-one patients under biologics were included. The average age was 43.4 years. There were 17 males and 14 females (sex ratio M/F 1,21). Cormibidities were hypertension and type 2 diabetes (9.7%), hypertension and dyslipidemia (6.5%), arrhythmia (6.5%), smoking (9.7%), hypertension and dysthyroidism (3.2%). All the patients were under biologics with an average duration of 2 years distributed as follows: 3 patients on etanercept (9.67%), 8 patients on tocilizumab (28.8%), 10 patients on infliximab (32.25%), 5 patients on adalimumab (16.12%)), 4 patients under golimumab (12.90%), 1 under secukinumab (3.22%). Biologics were associated with conventional synthetic disease-modifying antirheumatic drugs in 38.7% (methotrexate 12.9%, salosopyrine25, 8%), corticosteroids in 25.7%, non-steroidal anti-inflammatory drugs in 16.1%. The disease activity before COVID-19 of the patients was: 48.39% weak activity, 35.4% remission, 16.13% moderate activity. No patient reported a flare of the disease. During lockdown, 5 patients reported a flare of their disease (16.12%) They were followed for: 2 spondyloarthritis, 1 rheumatoid arthritis, 1 psoriatic arthritis, 1 adult onset Still s disease. All the patients have temporarily stopped their drugs because they couldn t come to their appointments because of the lockdown. Conclusion: Our study notes that the patients who kept their follow-up during lockdown have maintained a control of their disease activity. Our results are consistent with the observations of a French study on the impact of lockdown on the activity of rheumatoid arthritis. However, those who couldn t come to their control appointment due to the lockdown had a flare of their disease. This study remains limited due to the monocentric nature and the small size of our sample.