key: cord-283279-1qcdnd1y
authors: Barberio, Brigida; Zingone, Fabiana; Bertani, Lorenzo; Savarino, Edoardo
title: The Adherence to Infusible Biologic Therapies in Inflammatory Bowel Disease Patients During COVID-19 Pandemic: Is It Really a Problem?
date: 2020-07-17
journal: Gastroenterology
DOI: 10.1053/j.gastro.2020.07.017
sha: 
doc_id: 283279
cord_uid: 1qcdnd1y

nan

We read with great interest the nationwide retrospective study by Khan et al. 1 a evaluating the adherence to infusible biologic therapies, defined as receiving an infusion within ten weeks of the prior infusion, in patients with Inflammatory Bowel Disease (IBD) during the current Coronavirus disease 2019 (COVID-19) pandemic. The authors compared the adherence to infusion therapy between a cohort of IBD subjects, who received infusible biologic therapies during COVID-19, and another cohort of IBD patients who underwent the same therapies in 2019. They found that the adherence decreased from 84.6% in 2019 to 73.6% during the 2020 CoVID-19 crisis, thus recording a drop in the weekly number of infusions in their center since late March 2020. Finally, this exploratory analysis also confirmed a significant association between nonadherence to biologics infusion and the subsequent risk of corticosteroid requirement.

In order to evaluate the impact of COVID-19 and the following lockdown on the routine activities of our Gastroenterology Unit, we collected data from all accesses for infusible biologic therapies to our Infusion Center, between the 8 th of January and the 7 th of February (pre-lockdown) and between the 8 th of March and the 7 th of April (after the lockdown and CoVID-19 breakout). 2 In contrast with Khan and coworkers we did not observe a particular reduction of activity compared to the pre-lockdown period (280 vs 263) and at the same time we did not observe an increase of corticosteroid need or hospitalization among our IBD patients. 2 Surely, this pandemic with the extraordinary measures to contain the viral spread captured the public attention and generated misconceptions and fears. 3 To that end, a recent survey, conducted on a German cohort of 715 IBD patients to investigate their perception of the emergency and their medication compliance, demonstrated that the fear was more pronounced in patients taking immunosuppressants. In particular, they were concerned about interactions between medication and COVID-19. 4 Nevertheless, 96.4% of patients adhered to their medication schedule. 4 Therefore, the rapid countermeasures adopted at many IBD centers, including ours, such as the implementation of telemedicine and distance education allowed to reassure IBD patients about the lack of risk related to COVID-19 infection. 4, 5 For instance, at our Center, one week before the infusion, patients were contacted by email to reassure about the lack of risk in moving to the Hospital and the benefit of continuing medical therapy. Moreover, the day before the infusion each patient was contacted by phone in order to confirm the appointment and to explain the measures adopted to reduce the risks for all the patients entering to the Hospital (i.e. triage for potential COVID infection). Finally, a mobile phone number was provided to the patients in case of doubts or concerns. These experiences teach that a greater contact and dialogue with IBD patients is important to reassure them and also to provide the correct information and psychological support. We should explain to our patients with chronic diseases why it is important that they adhere to therapies which are relative safe and manageable despite the COVID-19 pandemic. 6 

Adherence of infusible biologics during the time of COVID-19 among patients with Inflammatory Bowel Disease: A nationwide VA cohort study

No need of transforming gastroenterology units to covid units at the time of SARS-COV2 infection-a single-center analysis from northern italy. Digestive and Liver Disease

Knowledge and Perceptions of COVID-19 Among the General Public in the United States and the United Kingdom: A Cross-sectional Online Survey

Pandemic-the Patients 'Perspective

Medical and gastroenterological education during the COVID-19 outbreak

Safety of drugs during previous and current coronavirus pandemics: Lessons for IBD. Journal of Crohn's and Colitis