There are about 1.6 million Americans affected with inflammatory bowel diseases and about 4 million with auto-immune mediated arthritis such as Rheumatoid Arthritis and Ankylosing Spondylitis. What these disorders have in common is that they often are treated with a class of medication known as “Biologics”. Biologics are a very sophisticated class of medication that target specific molecules of the inflammatory cascade. Each biologic generally has a different target.
Patients that are now on these medications worry that these potent medications will be detrimental to their health in the COVID-19 pandemic. There is concern that they are more likely to be infected, and concern that if infected, they would have worse outcomes.
Thought leaders from the American Gastroenterological Association have met and a publication is due April 20 in the Journal of Gastroenterology regarding this topic. I feel fortunate to have a professional connection to the lead author Dr. David Rubin of the University of Chicago who let me have a copy of the pre-published paper.
The take home point is: DON’T STOP YOUR MEDS!
Some of these same biologics are being tested in treating COVID-19. Attenuating the inflammatory cascade may in fact be a benefit. Also, the risk of the disease flaring if biologics are stopped are increased. The way we treat a flare is with steroids. Steroids are not nearly as specific as to which part of the inflammatory cascade they shut down. They shut it all down. Sound familiar?
So walking around the pandemic on steroids ought to be more scary than walking around on a biologic.
Of course, IF you are infected with COVID, then it’s time to stop all immune suppressing medication until research shows the benefits outweigh the risks.