Research ArticleAccepted Article
Open Access
Concerns, healthcare use, and treatment interruptions in patients with common autoimmune rheumatic diseases during the COVID-19 pandemic
Michael George, Shilpa Venkatachalam, Shubhasree Banerjee, Joshua F. Baker, Peter A. Merkel, Kelly Gavigan, David Curtis, Maria I. Danila, Jeffrey R. Curtis and W. Benjamin Nowell
The Journal of Rheumatology November 2020, jrheum.201017; DOI: https://doi.org/10.3899/jrheum.201017
Michael George
University of Pennsylvania, Philadelphia, PA; Global Healthy Living Foundation, Upper Nyack, NY; University of Alabama at Birmingham, Birmingham, AL. Sources of support: MG is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases at the National Institutes of Health (K23 AR073931-01). “The Arthritis and Rheumatic Disease COVID-19 Project” has received sponsorship support specifically from the Patient-Centered Outcomes Institute (PCORI), Eli Lilly and Company, and Janssen Pharmaceutical. Conflict of Interest: Michael George has received research support from Bristol-Myers Squibb for unrelated work. Joshua Baker has received consulting fees from Bristol-Myers Squibb and Gilead. Peter Merkel has received consulting feeds from AbbVie, AstraZeneca, Biogen, Boeringher-Ingelheim, Bristol- Myers Squibb, Celgene, ChemoCentryx, CSL Behring, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, InflaRx, Insmed, Jannsen, Kiniksa, Magenta, Pfizer, Sparrow, and Talaris and research support from AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, Celgene, ChemoCentryx, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, and InflaRx and royalties from UpToDate. Maria Danila has received consulting fees from Amgen, Novartis, and Sanofi Regeneron and research support from Genentech, Pfizer, Boehringer, and Horizon for unrelated work. Jeffrey Curtis has received consulting fees from AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, and UCB and research support from AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, UCB. David Curtis, Kelly Gavigan, W Benjamin Nowell, and Shilpa Venkatachalam have no personal conflicts of interests to disclose and are employees of the Global Healthy Living Foundation (GHLF). GHLF receives grants, sponsorships and contracts from pharmaceutical manufacturers and private foundations. A full list of GHLF funders is publicly available here: https://www.ghlf.org/our-partners/. Corresponding author: Michael D. George, Division of Rheumatology, 5 White Building, 3400 Spruce St, Philadelphia, PA 19104. Email: michael.george{at}pennmedicine.upenn.edu
Shilpa Venkatachalam
University of Pennsylvania, Philadelphia, PA; Global Healthy Living Foundation, Upper Nyack, NY; University of Alabama at Birmingham, Birmingham, AL. Sources of support: MG is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases at the National Institutes of Health (K23 AR073931-01). “The Arthritis and Rheumatic Disease COVID-19 Project” has received sponsorship support specifically from the Patient-Centered Outcomes Institute (PCORI), Eli Lilly and Company, and Janssen Pharmaceutical. Conflict of Interest: Michael George has received research support from Bristol-Myers Squibb for unrelated work. Joshua Baker has received consulting fees from Bristol-Myers Squibb and Gilead. Peter Merkel has received consulting feeds from AbbVie, AstraZeneca, Biogen, Boeringher-Ingelheim, Bristol- Myers Squibb, Celgene, ChemoCentryx, CSL Behring, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, InflaRx, Insmed, Jannsen, Kiniksa, Magenta, Pfizer, Sparrow, and Talaris and research support from AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, Celgene, ChemoCentryx, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, and InflaRx and royalties from UpToDate. Maria Danila has received consulting fees from Amgen, Novartis, and Sanofi Regeneron and research support from Genentech, Pfizer, Boehringer, and Horizon for unrelated work. Jeffrey Curtis has received consulting fees from AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, and UCB and research support from AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, UCB. David Curtis, Kelly Gavigan, W Benjamin Nowell, and Shilpa Venkatachalam have no personal conflicts of interests to disclose and are employees of the Global Healthy Living Foundation (GHLF). GHLF receives grants, sponsorships and contracts from pharmaceutical manufacturers and private foundations. A full list of GHLF funders is publicly available here: https://www.ghlf.org/our-partners/. Corresponding author: Michael D. George, Division of Rheumatology, 5 White Building, 3400 Spruce St, Philadelphia, PA 19104. Email: michael.george{at}pennmedicine.upenn.edu
Shubhasree Banerjee
University of Pennsylvania, Philadelphia, PA; Global Healthy Living Foundation, Upper Nyack, NY; University of Alabama at Birmingham, Birmingham, AL. Sources of support: MG is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases at the National Institutes of Health (K23 AR073931-01). “The Arthritis and Rheumatic Disease COVID-19 Project” has received sponsorship support specifically from the Patient-Centered Outcomes Institute (PCORI), Eli Lilly and Company, and Janssen Pharmaceutical. Conflict of Interest: Michael George has received research support from Bristol-Myers Squibb for unrelated work. Joshua Baker has received consulting fees from Bristol-Myers Squibb and Gilead. Peter Merkel has received consulting feeds from AbbVie, AstraZeneca, Biogen, Boeringher-Ingelheim, Bristol- Myers Squibb, Celgene, ChemoCentryx, CSL Behring, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, InflaRx, Insmed, Jannsen, Kiniksa, Magenta, Pfizer, Sparrow, and Talaris and research support from AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, Celgene, ChemoCentryx, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, and InflaRx and royalties from UpToDate. Maria Danila has received consulting fees from Amgen, Novartis, and Sanofi Regeneron and research support from Genentech, Pfizer, Boehringer, and Horizon for unrelated work. Jeffrey Curtis has received consulting fees from AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, and UCB and research support from AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, UCB. David Curtis, Kelly Gavigan, W Benjamin Nowell, and Shilpa Venkatachalam have no personal conflicts of interests to disclose and are employees of the Global Healthy Living Foundation (GHLF). GHLF receives grants, sponsorships and contracts from pharmaceutical manufacturers and private foundations. A full list of GHLF funders is publicly available here: https://www.ghlf.org/our-partners/. Corresponding author: Michael D. George, Division of Rheumatology, 5 White Building, 3400 Spruce St, Philadelphia, PA 19104. Email: michael.george{at}pennmedicine.upenn.edu
Joshua F. Baker
University of Pennsylvania, Philadelphia, PA; Global Healthy Living Foundation, Upper Nyack, NY; University of Alabama at Birmingham, Birmingham, AL. Sources of support: MG is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases at the National Institutes of Health (K23 AR073931-01). “The Arthritis and Rheumatic Disease COVID-19 Project” has received sponsorship support specifically from the Patient-Centered Outcomes Institute (PCORI), Eli Lilly and Company, and Janssen Pharmaceutical. Conflict of Interest: Michael George has received research support from Bristol-Myers Squibb for unrelated work. Joshua Baker has received consulting fees from Bristol-Myers Squibb and Gilead. Peter Merkel has received consulting feeds from AbbVie, AstraZeneca, Biogen, Boeringher-Ingelheim, Bristol- Myers Squibb, Celgene, ChemoCentryx, CSL Behring, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, InflaRx, Insmed, Jannsen, Kiniksa, Magenta, Pfizer, Sparrow, and Talaris and research support from AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, Celgene, ChemoCentryx, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, and InflaRx and royalties from UpToDate. Maria Danila has received consulting fees from Amgen, Novartis, and Sanofi Regeneron and research support from Genentech, Pfizer, Boehringer, and Horizon for unrelated work. Jeffrey Curtis has received consulting fees from AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, and UCB and research support from AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, UCB. David Curtis, Kelly Gavigan, W Benjamin Nowell, and Shilpa Venkatachalam have no personal conflicts of interests to disclose and are employees of the Global Healthy Living Foundation (GHLF). GHLF receives grants, sponsorships and contracts from pharmaceutical manufacturers and private foundations. A full list of GHLF funders is publicly available here: https://www.ghlf.org/our-partners/. Corresponding author: Michael D. George, Division of Rheumatology, 5 White Building, 3400 Spruce St, Philadelphia, PA 19104. Email: michael.george{at}pennmedicine.upenn.edu
Peter A. Merkel
University of Pennsylvania, Philadelphia, PA; Global Healthy Living Foundation, Upper Nyack, NY; University of Alabama at Birmingham, Birmingham, AL. Sources of support: MG is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases at the National Institutes of Health (K23 AR073931-01). “The Arthritis and Rheumatic Disease COVID-19 Project” has received sponsorship support specifically from the Patient-Centered Outcomes Institute (PCORI), Eli Lilly and Company, and Janssen Pharmaceutical. Conflict of Interest: Michael George has received research support from Bristol-Myers Squibb for unrelated work. Joshua Baker has received consulting fees from Bristol-Myers Squibb and Gilead. Peter Merkel has received consulting feeds from AbbVie, AstraZeneca, Biogen, Boeringher-Ingelheim, Bristol- Myers Squibb, Celgene, ChemoCentryx, CSL Behring, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, InflaRx, Insmed, Jannsen, Kiniksa, Magenta, Pfizer, Sparrow, and Talaris and research support from AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, Celgene, ChemoCentryx, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, and InflaRx and royalties from UpToDate. Maria Danila has received consulting fees from Amgen, Novartis, and Sanofi Regeneron and research support from Genentech, Pfizer, Boehringer, and Horizon for unrelated work. Jeffrey Curtis has received consulting fees from AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, and UCB and research support from AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, UCB. David Curtis, Kelly Gavigan, W Benjamin Nowell, and Shilpa Venkatachalam have no personal conflicts of interests to disclose and are employees of the Global Healthy Living Foundation (GHLF). GHLF receives grants, sponsorships and contracts from pharmaceutical manufacturers and private foundations. A full list of GHLF funders is publicly available here: https://www.ghlf.org/our-partners/. Corresponding author: Michael D. George, Division of Rheumatology, 5 White Building, 3400 Spruce St, Philadelphia, PA 19104. Email: michael.george{at}pennmedicine.upenn.edu
Kelly Gavigan
University of Pennsylvania, Philadelphia, PA; Global Healthy Living Foundation, Upper Nyack, NY; University of Alabama at Birmingham, Birmingham, AL. Sources of support: MG is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases at the National Institutes of Health (K23 AR073931-01). “The Arthritis and Rheumatic Disease COVID-19 Project” has received sponsorship support specifically from the Patient-Centered Outcomes Institute (PCORI), Eli Lilly and Company, and Janssen Pharmaceutical. Conflict of Interest: Michael George has received research support from Bristol-Myers Squibb for unrelated work. Joshua Baker has received consulting fees from Bristol-Myers Squibb and Gilead. Peter Merkel has received consulting feeds from AbbVie, AstraZeneca, Biogen, Boeringher-Ingelheim, Bristol- Myers Squibb, Celgene, ChemoCentryx, CSL Behring, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, InflaRx, Insmed, Jannsen, Kiniksa, Magenta, Pfizer, Sparrow, and Talaris and research support from AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, Celgene, ChemoCentryx, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, and InflaRx and royalties from UpToDate. Maria Danila has received consulting fees from Amgen, Novartis, and Sanofi Regeneron and research support from Genentech, Pfizer, Boehringer, and Horizon for unrelated work. Jeffrey Curtis has received consulting fees from AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, and UCB and research support from AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, UCB. David Curtis, Kelly Gavigan, W Benjamin Nowell, and Shilpa Venkatachalam have no personal conflicts of interests to disclose and are employees of the Global Healthy Living Foundation (GHLF). GHLF receives grants, sponsorships and contracts from pharmaceutical manufacturers and private foundations. A full list of GHLF funders is publicly available here: https://www.ghlf.org/our-partners/. Corresponding author: Michael D. George, Division of Rheumatology, 5 White Building, 3400 Spruce St, Philadelphia, PA 19104. Email: michael.george{at}pennmedicine.upenn.edu
David Curtis
University of Pennsylvania, Philadelphia, PA; Global Healthy Living Foundation, Upper Nyack, NY; University of Alabama at Birmingham, Birmingham, AL. Sources of support: MG is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases at the National Institutes of Health (K23 AR073931-01). “The Arthritis and Rheumatic Disease COVID-19 Project” has received sponsorship support specifically from the Patient-Centered Outcomes Institute (PCORI), Eli Lilly and Company, and Janssen Pharmaceutical. Conflict of Interest: Michael George has received research support from Bristol-Myers Squibb for unrelated work. Joshua Baker has received consulting fees from Bristol-Myers Squibb and Gilead. Peter Merkel has received consulting feeds from AbbVie, AstraZeneca, Biogen, Boeringher-Ingelheim, Bristol- Myers Squibb, Celgene, ChemoCentryx, CSL Behring, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, InflaRx, Insmed, Jannsen, Kiniksa, Magenta, Pfizer, Sparrow, and Talaris and research support from AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, Celgene, ChemoCentryx, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, and InflaRx and royalties from UpToDate. Maria Danila has received consulting fees from Amgen, Novartis, and Sanofi Regeneron and research support from Genentech, Pfizer, Boehringer, and Horizon for unrelated work. Jeffrey Curtis has received consulting fees from AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, and UCB and research support from AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, UCB. David Curtis, Kelly Gavigan, W Benjamin Nowell, and Shilpa Venkatachalam have no personal conflicts of interests to disclose and are employees of the Global Healthy Living Foundation (GHLF). GHLF receives grants, sponsorships and contracts from pharmaceutical manufacturers and private foundations. A full list of GHLF funders is publicly available here: https://www.ghlf.org/our-partners/. Corresponding author: Michael D. George, Division of Rheumatology, 5 White Building, 3400 Spruce St, Philadelphia, PA 19104. Email: michael.george{at}pennmedicine.upenn.edu
Maria I. Danila
University of Pennsylvania, Philadelphia, PA; Global Healthy Living Foundation, Upper Nyack, NY; University of Alabama at Birmingham, Birmingham, AL. Sources of support: MG is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases at the National Institutes of Health (K23 AR073931-01). “The Arthritis and Rheumatic Disease COVID-19 Project” has received sponsorship support specifically from the Patient-Centered Outcomes Institute (PCORI), Eli Lilly and Company, and Janssen Pharmaceutical. Conflict of Interest: Michael George has received research support from Bristol-Myers Squibb for unrelated work. Joshua Baker has received consulting fees from Bristol-Myers Squibb and Gilead. Peter Merkel has received consulting feeds from AbbVie, AstraZeneca, Biogen, Boeringher-Ingelheim, Bristol- Myers Squibb, Celgene, ChemoCentryx, CSL Behring, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, InflaRx, Insmed, Jannsen, Kiniksa, Magenta, Pfizer, Sparrow, and Talaris and research support from AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, Celgene, ChemoCentryx, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, and InflaRx and royalties from UpToDate. Maria Danila has received consulting fees from Amgen, Novartis, and Sanofi Regeneron and research support from Genentech, Pfizer, Boehringer, and Horizon for unrelated work. Jeffrey Curtis has received consulting fees from AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, and UCB and research support from AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, UCB. David Curtis, Kelly Gavigan, W Benjamin Nowell, and Shilpa Venkatachalam have no personal conflicts of interests to disclose and are employees of the Global Healthy Living Foundation (GHLF). GHLF receives grants, sponsorships and contracts from pharmaceutical manufacturers and private foundations. A full list of GHLF funders is publicly available here: https://www.ghlf.org/our-partners/. Corresponding author: Michael D. George, Division of Rheumatology, 5 White Building, 3400 Spruce St, Philadelphia, PA 19104. Email: michael.george{at}pennmedicine.upenn.edu
Jeffrey R. Curtis
University of Pennsylvania, Philadelphia, PA; Global Healthy Living Foundation, Upper Nyack, NY; University of Alabama at Birmingham, Birmingham, AL. Sources of support: MG is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases at the National Institutes of Health (K23 AR073931-01). “The Arthritis and Rheumatic Disease COVID-19 Project” has received sponsorship support specifically from the Patient-Centered Outcomes Institute (PCORI), Eli Lilly and Company, and Janssen Pharmaceutical. Conflict of Interest: Michael George has received research support from Bristol-Myers Squibb for unrelated work. Joshua Baker has received consulting fees from Bristol-Myers Squibb and Gilead. Peter Merkel has received consulting feeds from AbbVie, AstraZeneca, Biogen, Boeringher-Ingelheim, Bristol- Myers Squibb, Celgene, ChemoCentryx, CSL Behring, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, InflaRx, Insmed, Jannsen, Kiniksa, Magenta, Pfizer, Sparrow, and Talaris and research support from AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, Celgene, ChemoCentryx, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, and InflaRx and royalties from UpToDate. Maria Danila has received consulting fees from Amgen, Novartis, and Sanofi Regeneron and research support from Genentech, Pfizer, Boehringer, and Horizon for unrelated work. Jeffrey Curtis has received consulting fees from AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, and UCB and research support from AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, UCB. David Curtis, Kelly Gavigan, W Benjamin Nowell, and Shilpa Venkatachalam have no personal conflicts of interests to disclose and are employees of the Global Healthy Living Foundation (GHLF). GHLF receives grants, sponsorships and contracts from pharmaceutical manufacturers and private foundations. A full list of GHLF funders is publicly available here: https://www.ghlf.org/our-partners/. Corresponding author: Michael D. George, Division of Rheumatology, 5 White Building, 3400 Spruce St, Philadelphia, PA 19104. Email: michael.george{at}pennmedicine.upenn.edu
W. Benjamin Nowell
University of Pennsylvania, Philadelphia, PA; Global Healthy Living Foundation, Upper Nyack, NY; University of Alabama at Birmingham, Birmingham, AL. Sources of support: MG is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases at the National Institutes of Health (K23 AR073931-01). “The Arthritis and Rheumatic Disease COVID-19 Project” has received sponsorship support specifically from the Patient-Centered Outcomes Institute (PCORI), Eli Lilly and Company, and Janssen Pharmaceutical. Conflict of Interest: Michael George has received research support from Bristol-Myers Squibb for unrelated work. Joshua Baker has received consulting fees from Bristol-Myers Squibb and Gilead. Peter Merkel has received consulting feeds from AbbVie, AstraZeneca, Biogen, Boeringher-Ingelheim, Bristol- Myers Squibb, Celgene, ChemoCentryx, CSL Behring, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, InflaRx, Insmed, Jannsen, Kiniksa, Magenta, Pfizer, Sparrow, and Talaris and research support from AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, Celgene, ChemoCentryx, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, and InflaRx and royalties from UpToDate. Maria Danila has received consulting fees from Amgen, Novartis, and Sanofi Regeneron and research support from Genentech, Pfizer, Boehringer, and Horizon for unrelated work. Jeffrey Curtis has received consulting fees from AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, and UCB and research support from AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, UCB. David Curtis, Kelly Gavigan, W Benjamin Nowell, and Shilpa Venkatachalam have no personal conflicts of interests to disclose and are employees of the Global Healthy Living Foundation (GHLF). GHLF receives grants, sponsorships and contracts from pharmaceutical manufacturers and private foundations. A full list of GHLF funders is publicly available here: https://www.ghlf.org/our-partners/. Corresponding author: Michael D. George, Division of Rheumatology, 5 White Building, 3400 Spruce St, Philadelphia, PA 19104. Email: michael.george{at}pennmedicine.upenn.edu
Abstract
Objective To assess concerns and healthcare-related behaviors of patients with autoimmune rheumatic diseases during the COVID-19 pandemic.
Methods Adults from the United States with rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), and systemic lupus erythematosus (SLE) from the ArthritisPower Patient-Powered Research Network and CreakyJoints patient community completed surveys. Concerns and behaviors were compared among patients with different autoimmune conditions, disease-modifying anti-rheumatic drug (DMARD) use, and geographic measures of urban status, income, education, and COVID-19 activity.
Results Among 1,517 participants (925 RA, 299 PsA, 185 AS, 108 SLE), mean age was 55.1 years, 88.3% were female, and 89.5% white. COVID-19 concerns were similar across the country and were higher in biologic users (p < 0.001). Avoidance of doctor’s office visits (56.6%) or laboratory testing (42.3%) and use of telehealth (29.5%) were more common in urban areas. Among participants on DMARDs without COVID-19 or other respiratory illness, 14.9% stopped a DMARD, with 78.7% of DMARD interruptions not recommended by a physician. DMARD stopping was more common participants with lower socioeconomic status and in participants who avoided an office visit [OR 1.46(1.04-2.04)] or reported lack of telehealth availability [OR 2.26(1.25-4.08)].
Conclusion In the early months of the COVID-19 pandemic, patients with RA, PsA, AS, and SLE frequently avoided office visits and laboratory testing. DMARD interruptions commonly occurred without the advice of a physician and were associated with socioeconomic status, office visits, and telehealth availability, highlighting the need for adequate healthcare access and attention to vulnerable populations during the pandemic.
In this issue
The Journal of Rheumatology
Vol. 52, Issue 12
1 Dec 2025
Accepted manuscript
Concerns, healthcare use, and treatment interruptions in patients with common autoimmune rheumatic diseases during the COVID-19 pandemic
Michael George, Shilpa Venkatachalam, Shubhasree Banerjee, Joshua F. Baker, Peter A. Merkel, Kelly Gavigan, David Curtis, Maria I. Danila, Jeffrey R. Curtis, W. Benjamin Nowell
The Journal of Rheumatology Nov 2020, jrheum.201017; DOI: 10.3899/jrheum.201017
Accepted manuscript
Concerns, healthcare use, and treatment interruptions in patients with common autoimmune rheumatic diseases during the COVID-19 pandemic
Michael George, Shilpa Venkatachalam, Shubhasree Banerjee, Joshua F. Baker, Peter A. Merkel, Kelly Gavigan, David Curtis, Maria I. Danila, Jeffrey R. Curtis, W. Benjamin Nowell
The Journal of Rheumatology Nov 2020, jrheum.201017; DOI: 10.3899/jrheum.201017
