Guidance for restarting inflammatory bowel disease therapy in patients who withheld immunosuppressant medications during COVID-19

International Organization for the Study of Inflammatory Bowel Diseases [IOIBD]

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Patients with inflammatory bowel diseases [IBD] are frequently treated with immunosuppressant medications. During the coronavirus disease 2019 [COVID-19] pandemic, recommendations for IBD management have included that patients should stay on their immunosuppressant medications if they are not infected with the severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2], but to temporarily hold these medications if symptomatic with COVID-19 or asymptomatic but have tested positive for SARS-CoV-2. As more IBD patients are infected globally, it is important to also understand how to manage IBD medications during convalescence while an individual with IBD is recovering from COVID-19. In this review, we address the differences between a test-based versus a symptoms-based strategy as related to COVID-19, and offer recommendations on when it is appropriate to consider restarting IBD therapy in patients testing positive for SARS-CoV-2 or with clinical symptoms consistent with COVID-19. In general, we recommend a symptoms-based approach, due to the current lack of confidence in the accuracy of available testing and the clinical significance of prolonged detection of virus via molecular testing.

Original languageEnglish
Pages (from-to)S769-S773
JournalJournal of Crohn's and Colitis
Volume14
DOIs
StatePublished - 1 Oct 2020

Keywords

  • Biologic
  • Crohn's
  • De-escalation
  • IBD
  • Immunomodulator

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