VIDEO: COVID-related concerns in RA

Editor’s note: This is a previously posted video, and the below is an automatically generated transcript to be used for informational purposes. Please notify dstatman@healio.com if there are concerns regarding accuracy of the transcription.

This pandemic with COVID-19 is always throwing us for loops, right? But I think we're getting a better handle on this disease. I think we are now having better tools to be able to treat patients who get infected with COVID-19. And so, in my patients who are vaccinated, I'm not as worried compared to my patients who are unvaccinated. And if they're vaccinated and they have had the infection before, I'm really not that worried at all. Now, there are certain patient populations that I do worry about. Not just my unvaccinated patients, but patients who are really potent immunosuppressants. And when I say really potent immunosuppressants, I'm talking about being on prednisone more than 20 milligrams a day, being on rituximab, or being on a lot of cytotoxic medication, like combination therapies that can pretty much suppress your immune system. The good news is that we have pre-exposure prophylaxis with Evusheld. So these are monoclonal antibodies that are developed, antibodies against the SARS-CoV-2 virus. So people who've been vaccinated, or who can't tolerate the vaccine, who don't have enough antibodies. These patients who are at high risk for hospitalization, high risk for death from COVID-19 are eligible to receive the preexposure prophylaxis. It's two shots and it's given about every six months. Anyways, the data from the "New England Journal of Medicine" was published showing that Evusheld was very efficacious against the development of severe COVID-19. So in my patients who are on rituximab, who are on high-dose steroids, who don't respond, like my patients with combined variable immunodeficiency who really don't have antibody response to vaccines, I actually offer them Evusheld, so that way they might have some degree of protection. But for the rest of my patients, patients who have already received three doses of the COVID vaccine, I encourage them to go ahead and get the fourth dose. Now, the FDA says that the fifth dose is available for patients who are immunosuppressed. I have not recommended that yet because we really don't have data in rheumatic disease patients yet. Now, the guidelines are gonna change, the American College of Rheumatology might issue new guidelines regarding this, but in terms of where we are now in the pandemic, I think that we have a better handle on the disease. I feel more comfortable with my patients traveling, if they wanna eat out, if they want to socialize with their friends. I mean, be smart about it. Know your degree of comfort. If it's gonna be a room of crowded people, there's no ventilation, try to avoid it, because it's not just COVID-19 you might catch, it might be other viruses, as well.