AGA Publishes Clinical Practice Guidelines for Patients with IBD During the COVID-19 Pandemic

Updates from the International Registry

The registry now has data on 457 patient with IBD (Crohn’s disease and Ulcerative Colitis).  I will update with more detail later this week but the overall picture is as noted below.

• Take home points from the registry:

• 70% of identified patients did not require admission. Only 18 patients  required being in the ICU, 17 were placed on a ventilator and 15 deaths occurred.  This does not appear to be higher than the general population.

• Being on medications such as Humira, Remicade, Entyvio, Stelara, Xeljanz, methotrexate, Imuran or 6mp does not appear to be associated with an increased risk of bad outcomes or death

• Being on more than one medication and or being on prednisone may be associated with an increased risk

The American Gastroenterological Association has a Clinical Guideline for Mangaement of IBD Patient During the COVID-19 Pandemic summarized below.

AGA Clinical Practice Update on Management of  Inflammatory bowel disease During the COVID-19 Pandemic  Expert Commentary:  To appear in the  journal Gastroenterology

• Patients with IBD do not appear to be at higher risk for infection for COVID

• Patients with IBS who do not have infection with COVID-19 should NOT discontinue their IBD therapies

• Patients with IBD who develop COVID-19 should hold thiopurines: Imuran (azathioprine) Purinethol (6MP) , methotrexate, Tofacitinib(Xeljfanz) and biological therapies (Remicade, Simponi, Cimzia, Stelara, Entyvio).  These may be restarted after complete symptoms resolution or, if available, when follow-up testing is negative or serologic tests demonstrate the convalescent stage of illness.

However I advise all patients on more than one immunosuppressing medication and/or steroids to speak to there doctors about their dosages.  Call your doctor immediately if you have any upper respiratory symptoms or fever.

Please remember to wear a face mask when going out, wash your hands follow CDC guidelines regarding handwashing and practice social distancing.