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Science & Research

Medication Guidance Amidst COVID19: What the ACR Recommends

Some of our clients have had their treatments postponed amidst the COVID-19 crisis, and our coaching team has been getting questions about these new procedures. We wanted to shed some light on detailed information coming from professional medical organizations. On April 13th, 2020 the American College of Rheumatology (ACR) issued a guidance document for the care of adult patients with rheumatic diseases.  Fourteen disease specialists created this report to use as guidance for patients with stable and newly diagnosed disease, and separated the recommendations according to infection risk.


It’s always recommended to ask your physician directly, but we are here to summarize the recommended guidelines.


  • For all autoimmune disease patients, follow hand-washing and social distancing procedures as outlined by the Center for Disease Control and all US public health agencies. Appointments with your specialists and lab monitoring may be reduced in order to limit potential for SARS-CoV-2 exposure although telehealth visits may be encouraged. Some immune suppressing medications such as prednisone should be used at the lowest doses, unless you are at risk of vital organ failure (kidney, lung, liver, heart, etc.).


  • If you have a stable disease and have not been exposed to the SARS-CoV-2 virus, then you may continue your medications. An additional medication may be prescribed in order to prolong treatment effects and reduce visits to your doctor. If you have risk of organ failure, steroids and immunosuppressant meds could be increased, or you may be started on a biologic agent.


  • If you have been exposed to SARS-CoV-2 and are without symptoms then your doctor may advise you to stop immunosuppressants, non-IL-6 biologics, and JAK inhibitors until you are 2 weeks past recovery from COVID-19, or for 2 weeks after showing no symptoms. 


  • If you have tested positive for COVID-19, regardless of how severe your symptoms, you will be advised to continue plaquenil and other antimalarial therapies but to stop immunosuppressants, biologics and biosimilars. If you have breathing and respiratory symptoms, then antiinflammatories such as NSAIDS should be stopped. 


Have more questions about how you can protect yourself? Check out our COVID-19 and Autoimmunity: What You Need to Know Blog Series.  Consult your personal physician before you make any changes to your medications.


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