Assessing the Effect of Antimalarial Drug Shortages in Rheumatic Disease During the COVID-19 Pandemic

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The COVID-19 Global Rheumatology Alliance Patient Experience Survey was used to assess the effect of antimalarial drug shortages during the COVID-19 pandemic.

The following article is a part of conference coverage from the American College of Rheumatology Convergence 2020, being held virtually from November 5 to 9, 2020. The team at Rheumatology Advisor will be reporting on the latest news and research conducted by leading experts in rheumatology. Check back for more from the ACR Convergence 2020.

Patients with rheumatic diseases from African and South-East Asian regions vs American and European regions reported greater difficulty in obtaining antimalarial drugs during the coronavirus disease 2019 (COVID-19) pandemic and had worse mental and physical outcomes, according to survey results presented at the American College of Rheumatology (ACR) Convergence 2020, held virtually between November 5 to 9, 2020. Results also indicated that antimalarial drugs for rheumatic disease treatment did not have a protective effect against COVID-19 infection or hospitalizations as a result of COVID-19.

To assess the effect of antimalarial drug shortages during the COVID-19 pandemic in patients with rheumatic diseases, the COVID-19 Global Rheumatology Alliance Patient Experience Survey was distributed online to patients or parents of pediatric patients who anonymously entered relevant data, including rheumatic disease diagnosis, medications, COVID-19 status, and disease outcomes. The primary outcome measure was the effect of drug shortages on patient disease activity, mental health, and physical health.

Of 9393 survey respondents (mean age, 46.1±12.8 years; 90.0% women), 6334 (67.4%) were White and 1576 (16.8%) were Latin American. A majority of patients (70.9%) were also receiving conventional synthetic disease-modifying antirheumatic drugs (csDMARDs).

Among 3872 respondents receiving antimalarial drugs, 230 (6.2%) discontinued treatment due to drug shortages at their pharmacy. Compared with 6.8% of patients in the Americas and 2.1% in European regions, 21.4% in South-East Asia and 26.7% in African regions were affected by the inadequate supply of antimalarial drugs.

Overall, there were similar rates of COVID-19 infection among patients who received antimalarial drugs vs those who did not (6.7% vs 4.7%, respectively). Of 519 patients who were diagnosed with COVID-19, 68 (13.1%) indicated that their antimalarial medications were prescribed for the treatment of COVID-19 infection.

Patients who were unable vs able to obtain their antimalarial medications experienced higher levels of rheumatic disease activity (5.1 vs 4.3; t(244)=4.44; P <.001), poorer mental health (5.8 vs 6.3; t(252)=3.82; P <.001), and poorer physical health (5.6 vs 6.4; t(254)=5.97; P <.001).

Patients in certain regions, particularly Africa and South-East Asia, were found to be more affected by antimalarial drug shortages, a reminder of the “unintended harmful consequence of repurposing antimalarials without adequate evidence or benefit,” emphasizing “the importance of maintaining scientific rigor even in the context of a pandemic,” the study authors concluded.

Disclosures: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

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Sirotich E, Kennedy K, Surangiwala S, et al. Antimalarial drug shortages during the COVID-19 pandemic: results from the global rheumatology alliance patient experience survey. Presented at: ACR Convergence 2020; November 5-9, 2020. Abstract 0007.