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Review
. 2021 Jun;24(6):733-745.
doi: 10.1111/1756-185X.14124. Epub 2021 May 4.

Updated APLAR consensus statements on care for patients with rheumatic diseases during the COVID-19 pandemic

Lai-Shan Tam  1 , Yoshiya Tanaka  2 , Rohini Handa  3 , Zhanguo Li  4 , Jose Paulo Lorenzo  5 , Worawit Louthrenoo  6 , Catherine Hill  7 , Kevin Pile  8 , Philip C Robinson  9 , Leonila F Dans  10 , Li Yang Hsu  11 , Sang-Min Lee  12 , Jiacai Cho  13 , A T M Tanveer Hasan  14 , Babur Salim  15 , Saba Samreen  15 , Syahrul Sazliyana Shaharir  16 , Priscilla Wong  1 , Jeffrey Chau  17 , Debashish Danda  18 , Syed Atiqul Haq  19
Affiliations
Review

Updated APLAR consensus statements on care for patients with rheumatic diseases during the COVID-19 pandemic

Lai-Shan Tam et al. Int J Rheum Dis. 2021 Jun.

Abstract

Aim: To update previous guidance of the Asia Pacific League of Associations for Rheumatology (APLAR) on the management of patients with rheumatic and musculoskeletal diseases (RMD) during the coronavirus disease 2019 (COVID-19) pandemic.

Methods: Research questions were formulated focusing on diagnosis and treatment of adult patients with RMD within the context of the pandemic, including the management of RMD in patients who developed COVID-19. MEDLINE was searched for eligible studies to address the questions, and the APLAR COVID-19 task force convened 2 meetings through video conferencing to discuss its findings and integrate best available evidence with expert opinion. Consensus statements were finalized using the modified Delphi process.

Results: Agreement was obtained around key aspects of screening for or diagnosis of COVID-19; management of patients with RMD without confirmed COVID-19; and management of patients with RMD with confirmed COVID-19. The task force achieved consensus on 25 statements covering the potential risk of acquiring COVID-19 in RMD patients, advice on RMD medication adjustment and continuation, the roles of telemedicine and vaccination, and the impact of the pandemic on quality of life and on treatment adherence.

Conclusions: Available evidence primarily from descriptive research supported new recommendations for aspects of RMD care not covered in the previous document, particularly with regard to risk factors for complicated COVID-19 in RMD patients, modifications to RMD treatment regimens in the context of the pandemic, and COVID-19 vaccination in patients with RMD.

Keywords: APLAR guidance; Asia Pacific; SARS-CoV-2; consensus; rheumatic disease.

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Conflict of interest statement

L‐S Tam has consulted for Janssen, Pfizer, Sanofi, AbbVie, Boehringer Ingelheim and Lilly, and has received research grants from Amgen, Boehringer Ingelheim, Janssen, GlaxoSmithKline, Novartis and Pfizer. Y Tanaka has received speaking fees and/or honoraria from Daiichi Sankyo, Eli Lilly, Novartis, YL Biologics, Bristol Myers Squibb, Eisai, Chugai, AbbVie, Astellas, Pfizer, Sanofi, Asahi‐Kasei, GlaxoSmithKline, Mitsubishi‐Tanabe, Gilead and Janssen, and has received research grants from AbbVie, Mitsubishi‐Tanabe, Chugai, Asahi‐Kasei, Eisai, Takeda, and Daiichi Sankyo. PC Robinson reports personal fees from AbbVie, Eli Lilly, Gilead and Roche; grants and personal fees from Novartis, Janssen, UCB Pharma and Pfizer; and non‐financial support from Bristol Myers Squibb, outside the submitted work. The remaining authors disclose no conflicts of interest.

References

    1. Tam LS, Tanaka Y, Handa R, et al. Care for patients with rheumatic diseases during COVID‐19 pandemic: a position statement from APLAR. Int J Rheum Dis. 2020;23(6):717‐722. - PMC - PubMed
    1. Guyatt GH, Oxman AD, Kunz R, et al. Going from evidence to recommendations. [published correction appears in BMJ. 2008 ;336(7658): doi:10.1136/bmj.a402]. BMJ. 2008;336(7652):1049‐1051. - PMC - PubMed
    1. Balshem H, Helfand M, Schünemann HJ, et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol. 2011;64(4):401‐406. - PubMed
    1. Akiyama S, Hamdeh S, Micic D, Sakuraba A. Prevalence and clinical outcomes of COVID‐19 in patients with autoimmune diseases: a systematic review and meta‐analysis. Ann Rheum Dis. 2021;80(3):384‐391. 10.1136/annrheumdis-2020-218946 - DOI - PubMed
    1. Ye C, Cai S, Shen G, et al. Clinical features of rheumatic patients infected with COVID‐19 in Wuhan, China. Ann Rheum Dis. 2020;79(8):1007‐1013. - PMC - PubMed

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