Many patients with IBD who develop COVID-19 should stop their medication.
Bethesda, Maryland (April 10, 2020) — Today, the American Gastroenterological Association (AGA) published new COVID-19 guidance for gastroenterologists treating patients with inflammatory bowel disease (IBD): AGA Clinical Practice Update on Management of Inflammatory Bowel Disease During the COVID-19 Pandemic: Expert Commentary.
While the COVID-19 pandemic is a global health emergency, patients with IBD have particular concerns for their risk for infection and management of their medical therapies. This clinical practice update incorporates the emerging understanding of COVID-19 and summarizes available guidance for patients with IBD and the providers who take care of them.
Recommendations for gastroenterologists & their patients who have IBD:
- 1. During this pandemic, patients with IBD should continue IBD therapies including scheduled infusions.
- 2. Having IBD does not appear to increase the risk of SARS-CoV-2 infection or the development of COVID-19.
- 3. Instructions for patients with IBD who develop COVID-19 (fever, respiratory symptoms, digestive symptoms, etc.):
a. Stop thiopurines, methotrexate, tofacitinib.
b. Stop biological therapies (including anti-TNF, ustekinumab, vedolizumab).
c. Can restart therapies after complete resolution of COVID-19 symptoms. Patients should always speak with their health care team before stopping any medication.
- 4. Doctors should submit cases of IBD and confirmed COVID-19 to the SECURE-IBD registry at COVIDIBD.org.
This paper, authored by leading IBD experts David T. Rubin, Joseph D. Feuerstein, Andrew Y. Wang, and Russell D. Cohen, is published in Gastroenterology, the official journal of the AGA. This expert commentary was commissioned and approved by the AGA Institute Clinical Practice Updates Committee and the AGA Governing Board to provide timely perspective on a topic of high clinical importance to AGA membership.
ABOUT IBD Inflammatory bowel disease (IBD) is a group of chronic immune disorders, including Crohn’s disease and ulcerative colitis. These conditions can cause abdominal pain, diarrhea and weight loss. Symptoms and progression of the disease can often be controlled by medication, but sometimes surgery is needed, as well. In the U.S., 3.1 million people have IBD. Learn more about IBD in the AGA GI Patient Center.
Reference: Rubin DT, Feuerstein JD, Wang AY, Cohen RD, AGA Clinical Practice Update on Management of Inflammatory Bowel Disease During the COVID-19 Pandemic: Expert Commentary, Gastroenterology (2020), https://doi.org/10.1053/j.gastro.2020.04.012
About the AGA Institute The American Gastroenterological Association is the trusted voice of the GI community. Founded in 1897, the AGA has grown to more than 16,000 members from around the globe who are involved in all aspects of the science, practice and advancement of gastroenterology. The AGA Institute administers the practice, research and educational programs of the organization. www.gastro.org.
About Gastroenterology Gastroenterology, the official journal of the AGA Institute, is the most prominent scientific journal in the specialty and is in the top 1 percent of indexed medical journals internationally. The journal publishes clinical and basic science studies of all aspects of the digestive system, including the liver and pancreas, as well as nutrition. The journal is abstracted and indexed in Biological Abstracts, Current Awareness in Biological Sciences, Chemical Abstracts, Current Contents, Excerpta Medica, Index Medicus, Nutrition Abstracts and Science Citation Index. For more information, visit www.gastrojournal.org.