Many patients with IBD who develop COVID-19 should stop their medication

AMERICAN GASTROENTEROLOGICAL ASSOCIATION

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.

1. Doctors should submit cases of IBD and confirmed COVID-19 to the SECURE-IBD registry at COVIDIBD.org.

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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.

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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