Impact of the COVID-19 pandemic on patients with rheumatoid arthritis: data from the Ontario Best Practices Research Initiative (OBRI)

Abstract

Objectives The COVID-19 pandemic created challenges for patients with rheumatoid arthritis (RA). We examined the potential impact of the pandemic on patient-reported outcomes (PROs), disease activity (DA), and medication profiles, comparing the periods pre-pandemic and during the pandemic. Methods Patients enrolled in the Ontario Best Practices Research Initiative were included if they had at least one visit with a physician or study interviewer within 12 months before and after the start of pandemic-related closures in Ontario (March 15th, 2020). Baseline characteristics, DA, PROs (i.e. Health Assessment Questionnaire Disability Index, Rheumatoid Arthritis Disease Activity Index (RADAI), European Quality of Life -5 Dimension Questionnaire), medication use and changes were included. Paired two-sample t-tests and McNamar’s tests were performed for continuous and categorical variables between time periods. Results The analytic sample consisted of 1508 patients, with a mean (SD) age of 62.7 (12.5 years), and 79% were female. Despite decreases in the number of in-person visits during the pandemic, there was no significant negative impact on DA or PRO scores. The DA scores in both periods remained low, with either no clinically significant differences or patients slightly improved. Scores for mental, social, and physical health were either stable or improved. There were statistically significant decreases in conventional synthetic DMARD use (p < 0.0001) and increased JAK inhibitor usage (p = 0.0002). Biologic DMARD use remained stable throughout the pandemic. Conclusion In this cohort, DA and PROs of RA patients remained stable during the COVID-19 pandemic. The longer-term outcomes of the pandemic warrant investigation.

Access to biologics and JAK inhibitors for the treatment of rheumatic diseases in the biosimilars era in Poland: nation-level study

“…Data from Canada indicate that disease activity in RA patients remained stable during the COVID -19 pandemic, with high persistence in bDMARD therapy and a significant increase in JAKi use. 49 In the present study, we have shown impaired adherence to intravenous a hospital -based, specialist -driven decisions. At the same time, regulations that would encourage the use of more affordable bDMARDs are limited, which leads to savings reallocation into enhanced access to other, higher -priced drugs.…”