Should you continue your biologics if you get a positive COVID-19 test?
If you have ulcerative colitis, you may have heard that some types of UC medicine may affect your risk of severe COVID-19. So what should you do about your treatment regimen after a COVID-19 diagnosis?
Ulcerative Colitis Medicine with COVID-19
Not all UC treatments are risky during active COVID-19. Some have bigger effects on your COVID-19 than others. If you have ulcerative colitis, it’s important to talk to your doctor about what to do about your medicine if you get COVID-19. It’s better to have this conversation early—before you get COVID-19—but it’s never too late.
Glucocorticoids are a steroid medicine to reduce inflammation and symptoms during an active ulcerative colitis flare. They work by suppressing the immune system, which is overactive during a flare. Glucocorticoids are great at getting a flare under control; however, they also increase the risk of severe COVID-19.
Your best bet is to try to prevent a UC flare altogether during the pandemic. This way, you can reduce the need for glucocorticoids. If there’s no flare, there’s no need for glucocorticoids. Tips for preventing a flare during the pandemic include:
- Following a healthy lifestyle
- Managing stress
- Avoiding your UC triggers
- Sticking to your prescribed treatment
If you’re already on a course of glucocorticoids when you get a COVID-19 diagnosis, talk to your doctor. There are risks and benefits of quitting glucocorticoids during active COVID-19, so it’s going to be an individualized decision based on your health factors.
Biologics like anti-TNF therapy do not seem to increase the risk of severe COVID-19. That’s great news because it means sticking to your regular treatment may help prevent a flare (thus preventing the need for glucocorticoids). Once again, you should still discuss this decision with your doctor.
“In some situations, the therapy might be delayed or pushed to a different week or a different day,” says Maia Kayal, MD, gastroenterologist. This might help “allow your body to recover from COVID-19 before it gets a dose of the medication.”
Sticking to Your Treatment During the Pandemic
Whether you have COVID-19 or not, it’s important to follow your prescribed treatment regimen throughout the pandemic. Again, sticking to your treatment can help prevent a flare.
One of the ways to make it easier to stick to your treatment is to make sure that you have an adequate supply of medicines at all times. The pandemic has introduced a number of supply issues: shipping delays, low supplies, and more. You don’t want to be in a situation where you run out of medication and miss doses. This may lead to a flare, and thus increase your risk of needing glucocorticoids.
Finally, keep the lines of communication open with your doctor. Doctors and researchers are learning more every day about COVID-19 and its interactions with different medicines. As a result, your doctor can help you make the most informed decisions about your ulcerative colitis treatment during the pandemic—especially if you get a COVID-19 diagnosis.
Dr. Kayal is a gastroenterologist at Icahn School of Medicine at Mount Sinai.
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