Do your DMARDs put you at risk of COVID-19?
If you have rheumatoid arthritis (RA), you may be taking a medicine such as a disease-modifying anti-rheumatic drug (DMARDs), biologic, or JAK inhibitor. You might be wondering how these medicines affect your COVID-19 risk, and how you should be managing rheumatoid arthritis medicines during COVID-19.
While researchers still have more to learn, early data may give you hope. Your DMARDs and other RA medicines might have more benefits than risks during the COVID-19 pandemic.
How RA Medicines Work
DMARDs, biologics, and JAK inhibitors all work in slightly different ways, but they all alter the way the immune system functions. Conventional DMARDs more broadly suppress the entire immune system, whereas biologics and JAK inhibitors work in more specific ways.
For example, biologics for rheumatoid arthritis include tumor necrosis factor (TNF) inhibitors. Instead of generally suppressing the immune system, they target TNF, a cytokine that fuels inflammation. By inhibiting TNF, this medicine reduces symptoms (like joint pain, stiffness, and fatigue) and helps prevent long-term damage in the joints.
In general, these medicines for RA *can* increase the risk of certain infections. That’s why it’s important to know your risk level when it comes to COVID-19.
Are You at Risk?
The good news: The available data at this time suggest that DMARDs for RA do *not* significantly increase your risk of getting COVID-19. Additionally, they do not appear to increase the risk of complications from COVID-19.
The biggest risk might not be your medication, but your disease management. In other words, not having your RA under control might put you at a bigger risk of COVID-19 complications. For this reason, keeping up with your RA treatment regimen can be actually crucial and beneficial during the COVID-19 pandemic.
While continuing your treatment as usual may be the best course of action, this should ultimately be a shared decision between you and your doctor. You may have unique factors that require a different approach.
A Note on Steroids
When it comes to managing rheumatoid arthritis medicines during COVID-19, there’s one medication that deserves pause: corticosteroids. At this time, the role of corticosteroids in COVID-19 is controversial.
Corticosteroids can help manage a bad flare, but they may also increase the risk of hospitalization from infections. Corticosteroids are not generally recommended for long-term treatment of RA. However, if you are taking them, you should talk to your physician to see if you need to adjust or taper off your corticosteroids.
Staying Connected During the Pandemic
Staying on top of your prescriptions and doctor appointments can be challenging during the pandemic. Depending on your risk factors and where you live, you might be self-isolating at home. Additionally, you may have kids who are remote learning at home who need your presence.
One way to keep up with your treatment regimen without leaving home is telehealth. With telehealth, you can follow-up with your doctor virtually while staying safe at home. Doctors can even refill prescriptions for you to keep your supplies stocked through the pandemic.
If you’re concerned about managing rheumatoid arthritis medicines during COVID-19, or about managing your COVID-19 risk in general, talk to your doctor. They can help you make a personalized plan to maintain your best health.
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- COVID-19 Task Force guidance statements. National Psoriasis Foundation. (Accessed on September 15, 2020)
- Initial treatment of rheumatoid arthritis in adults. Waltham, MA: UpToDate, 2020. (Accessed on September 15, 2020)