In this MD Newsline exclusive interview with rheumatologist Dr. Maggie Cadet, we discuss rheumatoid arthritis management challenges and disparities during the COVID-19 pandemic.
What are the biggest challenges that rheumatologists are tasked with in the wake of COVID-19?
Dr. Maggie Cadet:
“It has been challenging to assuage our patients’ fears of getting vaccinated for COVID-19. A lot of our patients with rheumatoid arthritis are afraid of getting vaccinated because they’re worried the vaccination will precipitate a flare-up of their disease. And also, a lot of our patients are on immunosuppressant drugs such as biologics, JAK1 inhibitors, and high doses of steroids that may play a role in vaccination response.
So, what I do is I refer my patients to the American College of Rheumatology website. They do recommend in their guidelines that patients with rheumatoid arthritis and other autoimmune diseases get vaccinated because the risk of severe COVID-19 is worse than the side effects of the vaccine or a possible flare-up of their disease. And flares can be managed with steroids and other medications. Despite these guidelines, it’s still been challenging for our patients to feel confident in getting vaccinated for COVID-19.
The other big challenge is getting our patients to follow up. With the pandemic, patients have been afraid to come in to the office. And it’s important for them to follow up because some of their medications can really affect the kidneys, liver, and other serologic parameters. So, we need to keep track of that. Telehealth visits and bloodwork checks should be utilized.
Lastly, screening has also been a challenge during the pandemic. I remind my patients that rheumatoid arthritis affects other organs. And, we want to make sure our patients are getting screened for medication side effects like diabetes, hypertension, and other comorbidities.”
Do you think arthritis disparities have worsened during the COVID-19 pandemic?
Dr. Maggie Cadet:
“We do know that minority populations have been harder hit by COVID-19. Also, a lot of minority populations have other comorbidities like diabetes, COPD, hypertension, and kidney disease, and these disparities have been compounded by COVID-19.
As I was saying for my patients with rheumatoid arthritis who are hesitant to get vaccinated, some of them have gotten sick with COVID-19, which resulted in other problems on top of their arthritis, which has maybe impacted their disability.”
Responses have been condensed and lightly edited.