Physician practice patterns on holding inflammatory bowel disease medications due to COVID-19 in the SECURE-IBD registry

Agrawal, Manasi; Brenner, Erica J; Zhang, Xian; Colombel, Jean-Frederic; Kappelman, Michael D; Ungaro, Ryan C

BACKGROUND: We aimed to describe physician practice patterns on holding or continuing IBD therapy in the setting of COVID-19 infection using the Surveillance Epidemiology of Coronavirus Under Research Exclusion for Inflammatory Bowel Disease (SECURE-IBD) registry. METHODS: IBD medications that were stopped due to COVID-19 were recorded in the SECURE-IBD registry in addition to demographic and clinical data. We conducted descriptive analyses to understand characteristics associated with stopping IBD medications in response to active COVID-19 infection. RESULTS: Of 1,499 patients, IBD medications were stopped in 518 (34.6%) patients. On bivariate and multivariable analyses, a diagnosis of ulcerative colitis or IBD-unspecified was associated with a lower odds of stopping medication compared with Crohn’s disease [adjusted odds ratio (aOR) 0.6, 95% confidence interval (CI) 0.48, 0.75]. When evaluating specific medications, 5-aminosalicylic acid was more likely to be continued (p<0.001) while anti-tumor necrosis factor therapy and immunomodulator therapy were more likely to be stopped (global p <0.001). Other demographic and clinical characteristics did not impact prescription patters. CONCLUSION: IBD medications other than immunomodulators were continued in the majority of IBD patients with COVID-19 in the international SECURE-IBD registry. Future studies are needed to understand the impact of stopping or continuing IBD medications on IBD- and COVID-19-related outcomes.