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- antirheumatic agents
- biological therapy
- autoimmune diseases
- communicable diseases, imported
With respect to observations by Monti et al,1 a survey featuring 31 questions related to rheumatic diseases (RDs) during the covid-19 pandemic was administered to members of the Indian Rheumatology Association.
Of 861 invitees, 221 (25.7%; 92.7% adult rheumatologists, 52.2% academicians) responded. Most perceived the need for a change in the management of RDs (online supplementary files). Almost half (47.5%) reduced the usage of biological disease modifyinig anti rheumatic drugs (bDMARDs), whereas only 12.2% did so for csDMARDs (figure 1). Of the respondents, 66.5% were more inclined to initiate hydroxychloroquine (HCQ) in patients with borderline indications, whereas 14% disagreed with this approach. Nearly two-thirds (64.2%) were less inclined to change the major immunosuppressant (IS) for impending flare, with 58.3% deferring rituximab (RTX), followed closely by cyclophosphamide, antitumour necrosis factors (anti-TNFs), Janus kinase inhibitors (JAKinibs) and other bDMARDs. An earlier taper of glucocorticoids was preferred by 57.9% in inactive disease. There was lack of consensus on continuing IS infusions.
Correction notice This article has been corrected since it published Online First. Figure 1 has been replaced.
Contributors All authors were involved in ideation, data collection and manuscript preparation. All authors agree with the submitted version of the manuscript, take responsibility for the content of the entire manuscript and affirm that any queries related to any aspect of the same are appropriately managed.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval Exemption from review was obtained from the institute ethics committee of SGPGIMS, Lucknow as per local guidelines. The survey was completely anonymised and informed consent taken from the respondents at the beginning of the exercise.
Provenance and peer review Not commissioned; internally peer reviewed.
Data availability statement All data pertaining to the study are included in the manuscript and as supplementary material. Pre-prints are available at Medarxive at Gupta L, Misra D, Agarwal V, et al. Management of rheumatic diseases in the times of COVID-19 pandemic- perspectives of rheumatology practitioners from India. Rheumatology 2020. doi:10.1101/2020.04.03.20048389.