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Worsening of disease in those with spondyloarthritis during the COVID-19 lockdown

One patient group who have been particularly affected by the COVID-19 lockdown has been those with spondyloarthritis (SpA).

In a recent survey of 609 French patients, 63% stated that their disease had worsened during confinement and 28% had experienced a considerable deterioration of their disease. Moreover, 43% reported that confinement had led to them changing their treatment, mainly the use of NSAIDs, which are the reference treatment for SpA. In total, 39% had modified their intake of NSAIDs, 28% had completely stopped while 11% reduced their intake. This discontinuation of NSAIDs had occurred in the majority of cases without patients informing their physician and largely was as a result of warning about the use of these drugs in the context of COVID-19 which was highlighted in the media. In addition, NSAIDs were often discontinued when patients experienced a disease flare. Fortunately, only 11% of patients discontinued their DMARDS.

Although it was unclear from the survey whether treatment discontinuation led to a worsening of symptoms, another contributory factor was lack of physical activity which is known to reduce disease activity and is incorporated into patient treatment plans.

The authors recommended that patients be provided with evidence on NSAIDs and how to undertake physical activity at home, especially if further lockdown measures are introduced at a later date.

Roux CH et al. Impact of home confinement during the COVID-19 pandemic on medication use and disease activity in Spondyloarthritis patients. Arthritis Rheumatol [letter] 2020; June 17