key: cord-0722348-op59ahpr authors: Richette, Pascal; Allez, Matthieu; Descamps, Vincent; Perray, Lucas; Pilet, Simon; Latourte, Augustin; Maravic, Milka title: Impact of COVID-19 on initiation of biologic therapy prescriptions for chronic inflammatory diseases date: 2021-07-24 journal: Joint Bone Spine DOI: 10.1016/j.jbspin.2021.105253 sha: fffe5138cf37a96876cd49ff48e8a59a8994e82e doc_id: 722348 cord_uid: op59ahpr nan Pascal Richette 1,2 , Matthieu Allez 3 We studied the impact of COVID-19 on both the initiation and renewal of biologic prescriptions in 2020 by using 1) year 2019 as the reference and 2) dispensing delivery data from pharmacies. We studied weeks 2 to week 25 with a focus on the lockdown weeks (weeks 12-19). Data for 49,807 and 55,858 patients with at least 1 delivery of biologic agents in 2019 and 2020, respectively, were analyzed. Treatment initiation was defined as a treatment not delivered in the previous 12 months and the converse for treatment renewal. The impact of prescriptions was described at a national and regional level. Three French regions were considered: Grand-Est and Ile-De-France, with a large number of infected patients, compared to Pays-de-la-Loire, with a markedly lower prevalence of COVID-19. Overall, these reductions in prescription initiation were mainly observed in the area where the epidemic was more pronounced (i.e., East of France; p<0.01). We also looked at disease-modifying anti-rheumatic drugs and found a marked increase in HCQ prescription initiation (+173%; p<0.05, occurring mainly during the first 4 weeks of the lockdown: +492%, +646%, +127%, and +49% at weeks 12, 13, 14 and 15, respectively) but a significant decrease in prescription initiation of apremilast (-44%; p<0.001) and MTX (-30%; p<0.001). In contrast, we found no change in renewal of treatments, whatever the therapeutic class (data not shown). In conclusion, during the COVID-19 epidemic peak in France, we found a sharp increase in new prescriptions of both HCQ and tocilizumab, two drugs suspected to improve COVID-19 outcomes (4). By contrast, physicians less frequently prescribed other biologic agents, MTX and apremilast, as previously reported (5, 6) . The delay in the initiation of biologic therapy prescription might have affected the quality of care and might lead to worse outcomes . This point remains to be addressed by further studies. EULAR provisional recommendations for the management of rheumatic and musculoskeletal diseases in the context of SARS-CoV-2 Managing patients with rheumatic diseases during the COVID-19 pandemic: The French Society of Rheumatology answers to most frequently asked questions up to Crossvalidation of an algorithm detecting acute gastroenteritis episodes from prescribed drug dispensing data in France: comparison with clinical data reported in a primary care surveillance system, winter seasons 2014/15 to 2016/17 Old and new antirheumatic drugs for the treatment of COVID-19 Impact of the COVID-19 pandemic on therapeutic management of rheumatoid arthritis in Brittany (France) COVID-19 in French patients with chronic inflammatory rheumatic diseases: Clinical features, risk factors and treatment adherence