Sulfasalazine, RA and coronavirus

[Sallyb828]

Hi everyone, I'm just hoping for some clarification- I take hydroxychloroquine and sulfasalazine for my arthritis. From what I have read so far this means I am not at an increased risk, even though I was told previously that sulfasalazine did suppress the immune system? So am I still classed as an increased risk because I have RA anyway, and hence should I be isolating/not going out for food or exercise etc?- I work as a veterinary nurse so my practice still needs me at work ideally for emergencies only, however I appear to be having a flare up currently so am concerned about any additional risk so at present I'm staying home... Please can anyone advise me as I'm relatively new to the diagnosis (less than 2 years) Thank you x

[bunnycaramel]

Maybe you need to discuss with your GP

Have you received txt/letter from gov.com that should answer your question.

[Sallyb828 in reply to bunnycaramel]

No I haven't received a letter and think these are only being sent to those at high risk so I'm not expecting to. Have tried ringing my rheumatology clinic but they're inundated and I didn't want to keep ringing and cause more pressure on the NHS but thank you x

[charisma]

Hi Sally

All of us on RA meds are imunosuppressed but not necessarily at high risk. Gov is working with GPs to identify and write to high risk people.

I have not yet received a letter but another post or two here describe receiving theirs.

We should all be very careful even if not in high risk category. Since we cannot easily fight a virus, if feeling ill, we usually stop taking DMARDs like MTX till well.

If you are to to get a letter, it ought to be with you by Sat. maybe you could work till then? Take care.

[Sallyb828 in reply to charisma]

Thank you, I have seen a guide on the royal society of rheumatoid arthritis that said hydroxychloroquine and sulfasalazine are not classed as immunosuppressive drugs (whereas I was told that sulfasalazine is a mild immunosuppressant?!) So just all a little confusing as to risks and whether I am okay to work.

I've never been told about stopping them whilst ill either so thank you for that,

Much appreciated x

[charisma in reply to Sallyb828]

I had MTX and HCQ together. When ill or neutrophils low, always told to stop MTX but keep going with HCQ, usually till blood count ok again or virus gone.

The drugs we use as DMARDs do suppress the immune system but not as much as eg cancer drug doses.

Biologics are more suppressive but if given by IV cannot be paused.

There is confusion about a lot at the moment. Hope you stay well!

[Sallyb828 in reply to charisma]

Thank you, you too x

[bunnycaramel in reply to charisma]

At the moment I haven’t received a txt but assume I’m high risk because I am taking benepali and have bronchietasis and have had many chest infections in the last year with a hospital admission. I currently have a chest ingenious and taking antibiotics. I’ve been told it can take up to the 29th to be notified.

[helixhelix]

All the advice so far says that Sulpha and Hydroxy do not increase risk. Especially if you are young and otherwise healthy when the risk of the disease being serious is quite low anyway.

However, if you are having a flare it does seem as if that could make you more vulnerable. I think you need to discuss with your employer - they have a responsibility for your health and safety. Awkward as you probably won’t be getting the letter which will allow you to go on sick pay, but hopefully your employer will see that you need to be well protected.

[Sallyb828 in reply to helixhelix]

Thank you for explaining, much appreciated. As it stands I have taken two weeks off anyway and then will reassess, I just wanted to understand my risks before possibly going back to work (we are only seeing emergencies now at the vets)

X

[KarenS1]

Hi there

I am also on these two meds and was wondering if I would receive a letter, someone else on here included the below link which is useful in understanding this:

rheumatology.org.uk/News-Po...

As always I would check with GP as your situation may be different to mine or others but for me, taking these two meds doesn’t put me at high risk which I am very relieved about.

Keep well.

Karen

[Aber]

I am taking the same meds and find this whole matter very confusing and extremely stressful.

I have also not yet had a letter or text.

Hopefully we'll get some clarity in the next few days.

[KittyJ in reply to Aber]

Try not to stress about it as that will cause you other problems. Have a look at the risk stratification Karen posted above. You won’t be getting the letter if you’re just on those two meds but it’s your health and your life so you have to decide what you need to do for your safety and peace of mind if you have no advice from your doctors. Stay safe x

[Sallyb828]

Yep it's really difficult... I guess just having the condition in itself irrespective of what medication you take still increases the risk to some degree? but yes I think it will be difficult to choose to shield for 12 weeks without a letter and expect to get paid for it (unless you have a very reasonable employer!)

Sadly I'm self employed so also a bit stuck!

[Jamarruk]

rheumatology.org.uk/Portals...