Managing patients with rheumatic diseases during the COVID-19 pandemic: The French Society of Rheumatology answers to most frequently asked questions up to May 2020.
Identifieur interne : 000B34 ( Main/Exploration ); précédent : 000B33; suivant : 000B35Managing patients with rheumatic diseases during the COVID-19 pandemic: The French Society of Rheumatology answers to most frequently asked questions up to May 2020.
Auteurs : Christophe Richez [France] ; René-Marc Flipo [France] ; Francis Berenbaum [France] ; Alain Cantagrel [France] ; Pascal Claudepierre [France] ; Françoise Debiais [France] ; Philippe Dieudé [France] ; Philippe Goupille [France] ; Christian Roux [France] ; Thierry Schaeverbeke [France] ; Daniel Wendling [France] ; Thao Pham [France] ; Thierry Thomas [France]Source :
- Joint bone spine [ 1778-7254 ] ; 2020.
Abstract
BACKGROUND
Rheumatologists must contend with COVID-19 pandemic in the management of their patients and many questions have been raised on the use of both anti-inflammatory drugs and disease-modifying anti-rheumatic drugs (DMARD). The French Society of Rheumatology (SFR) selected the most critical ones to the daily practice of a rheumatologist and a group of 10 experts from SFR and Club Rheumatism and Inflammation (CRI) boards proposed responses based on the current knowledge of May 2020.
METHODS
Following the availability of the first 18 questions and statements, 1400 individuals consulted the frequently asked questions between the March 31, 2020 and April 12, 2020. As a result, 16 additional questions were forwarded to the SFR, and answered by the board. An additional round of review by email and video conference was organized, which included updates of the previous statements. The scientific relevance of 5 of the questions led to their inclusion in this document. Each response received a final assessment on a scale of 0-10 with 0 meaning no agreement whatsoever and 10 being in complete agreement. The mean values of these votes for each question are presented as the levels of agreement (LoA) at the end of each response. This document was last updated on April 17, 2020.
RESULTS
Based on current scientific literature already published, in most circumstances, there is no contraindication to the initiation or continuation of anti-inflammatory drugs as well as DMARDs. If signs suggestive of infection (coronavirus or other) occur, treatments should be discontinued and resumed, if necessary, after 2 weeks without any symptoms. Only, some signals suggest that people taking an immunosuppressive dose of corticosteroid therapy are at greater risk of developing severe COVID-19. Intra-articular injections of glucocorticoids are allowed when there is no reasonable therapeutic alternative, and providing that precautions to protect the patient and the practitioner from viral contamination are adopted, included appropriate information to the patient.
CONCLUSIONS
Currently available data on managing patients with rheumatic diseases during the COVID-19 pandemic are reassuring and support continuing or initiating symptomatic as well as specific treatments of these diseases, the main target of their management remaining their appropriate control, even during this pandemic.
DOI: 10.1016/j.jbspin.2020.05.006
PubMed: 32473418
PubMed Central: PMC7255274
Affiliations:
- France
- Aquitaine, Auvergne-Rhône-Alpes, Bourgogne-Franche-Comté, Centre-Val de Loire, Franche-Comté, Hauts-de-France, Midi-Pyrénées, Nord-Pas-de-Calais, Nouvelle-Aquitaine, Occitanie (région administrative), Poitou-Charentes, Provence-Alpes-Côte d'Azur, Rhône-Alpes, Région Centre, Île-de-France
- Besançon, Bordeaux, Créteil, Lille, Marseille, Paris, Poitiers, Saint-Étienne, Toulouse, Tours
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Francoise" sort="Debiais, Francoise" uniqKey="Debiais F" first="Françoise" last="Debiais">Françoise Debiais</name><affiliation wicri:level="3"><nlm:affiliation>Service de Rhumatologie, Centre Hospitalier Universitaire, 2, rue de la Milétrie, BP 577, 86021 Poitiers cedex, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, Centre Hospitalier Universitaire, 2, rue de la Milétrie, BP 577, 86021 Poitiers cedex</wicri:regionArea><placeName><region type="region" nuts="2">Nouvelle-Aquitaine</region><region type="old region" nuts="2">Poitou-Charentes</region><settlement type="city">Poitiers</settlement></placeName></affiliation></author><author><name sortKey="Dieude, Philippe" sort="Dieude, Philippe" uniqKey="Dieude P" first="Philippe" last="Dieudé">Philippe Dieudé</name><affiliation wicri:level="3"><nlm:affiliation>Service de Rhumatologie, Groupe Hospitalier Universitaire Bichat-Claude Bernard, 46, rue Henri-Huchard, 75018 Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, Groupe Hospitalier Universitaire Bichat-Claude Bernard, 46, rue Henri-Huchard, 75018 Paris</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Goupille, Philippe" sort="Goupille, Philippe" uniqKey="Goupille P" first="Philippe" last="Goupille">Philippe Goupille</name><affiliation wicri:level="3"><nlm:affiliation>Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Tours, Hôpital Trousseau, 37044 Tours cedex 9, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Tours, Hôpital Trousseau, 37044 Tours cedex 9</wicri:regionArea><placeName><region type="region" nuts="2">Centre-Val de Loire</region><region type="old region" nuts="2">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation></author><author><name sortKey="Roux, Christian" sort="Roux, Christian" uniqKey="Roux C" first="Christian" last="Roux">Christian Roux</name><affiliation wicri:level="3"><nlm:affiliation>Service de Rhumatologie, Centre Hospitalier Universitaire Cochin, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, Centre Hospitalier Universitaire Cochin, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Schaeverbeke, Thierry" sort="Schaeverbeke, Thierry" uniqKey="Schaeverbeke T" first="Thierry" last="Schaeverbeke">Thierry Schaeverbeke</name><affiliation wicri:level="3"><nlm:affiliation>Centre Hospitalier Universitaire de Bordeaux, FHU ACRONIM, place Amélie-Raba-Léon, 33076 Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Centre Hospitalier Universitaire de Bordeaux, FHU ACRONIM, place Amélie-Raba-Léon, 33076 Bordeaux</wicri:regionArea><placeName><region type="region" nuts="2">Nouvelle-Aquitaine</region><region type="old region" nuts="2">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Wendling, Daniel" sort="Wendling, Daniel" uniqKey="Wendling D" first="Daniel" last="Wendling">Daniel Wendling</name><affiliation wicri:level="3"><nlm:affiliation>Service de Rhumatologie, Centre Hospitalier Universitaire Jean-Minjoz, 1, boulevard Fleming, 25030 Besançon cedex, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, Centre Hospitalier Universitaire Jean-Minjoz, 1, boulevard Fleming, 25030 Besançon cedex</wicri:regionArea><placeName><region type="region" nuts="2">Bourgogne-Franche-Comté</region><region type="old region" nuts="2">Franche-Comté</region><settlement type="city">Besançon</settlement></placeName></affiliation></author><author><name sortKey="Pham, Thao" sort="Pham, Thao" uniqKey="Pham T" first="Thao" last="Pham">Thao Pham</name><affiliation wicri:level="3"><nlm:affiliation>Service de Rhumatologie, Centre Hospitalier Universitaire Sainte Marguerite, 270, boulevard de Sainte-Marguerite, 13274 Marseille cedex 9, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, Centre Hospitalier Universitaire Sainte Marguerite, 270, boulevard de Sainte-Marguerite, 13274 Marseille cedex 9</wicri:regionArea><placeName><region type="region" nuts="2">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement></placeName></affiliation></author><author><name sortKey="Thomas, Thierry" sort="Thomas, Thierry" uniqKey="Thomas T" first="Thierry" last="Thomas">Thierry Thomas</name><affiliation wicri:level="3"><nlm:affiliation>Department of Rheumatology, Hôpital Nord, CHU Saint-Étienne, Inserm U1059, Université de Lyon-Université Jean-Monnet, Saint-Étienne, France. Electronic address: thierry.thomas@chuse.fr.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Rheumatology, Hôpital Nord, CHU Saint-Étienne, Inserm U1059, Université de Lyon-Université Jean-Monnet, Saint-Étienne</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Saint-Étienne</settlement></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32473418</idno><idno type="pmid">32473418</idno><idno type="doi">10.1016/j.jbspin.2020.05.006</idno><idno type="pmc">PMC7255274</idno><idno type="wicri:Area/Main/Corpus">001038</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">001038</idno><idno type="wicri:Area/Main/Curation">001038</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">001038</idno><idno type="wicri:Area/Main/Exploration">001038</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Managing patients with rheumatic diseases during the COVID-19 pandemic: The French Society of Rheumatology answers to most frequently asked questions up to May 2020.</title><author><name sortKey="Richez, Christophe" sort="Richez, Christophe" uniqKey="Richez C" first="Christophe" last="Richez">Christophe Richez</name><affiliation wicri:level="3"><nlm:affiliation>Centre Hospitalier Universitaire de Bordeaux, FHU ACRONIM, place Amélie-Raba-Léon, 33076 Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Centre Hospitalier Universitaire de Bordeaux, FHU ACRONIM, place Amélie-Raba-Léon, 33076 Bordeaux</wicri:regionArea><placeName><region type="region" nuts="2">Nouvelle-Aquitaine</region><region type="old region" nuts="2">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Flipo, Rene Marc" sort="Flipo, Rene Marc" uniqKey="Flipo R" first="René-Marc" last="Flipo">René-Marc Flipo</name><affiliation wicri:level="3"><nlm:affiliation>Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Lille, Hôpital Roger Salengro, rue du Professeur-Emile-Laine, 59037 Lille cedex, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Lille, Hôpital Roger Salengro, rue du Professeur-Emile-Laine, 59037 Lille cedex</wicri:regionArea><placeName><region type="region" nuts="2">Hauts-de-France</region><region type="old region" nuts="2">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Berenbaum, Francis" sort="Berenbaum, Francis" uniqKey="Berenbaum F" first="Francis" last="Berenbaum">Francis Berenbaum</name><affiliation wicri:level="3"><nlm:affiliation>Service de Rhumatologie, Centre Hospitalier Universitaire Saint-Antoine, 184, rue du Faubourg-Saint-Antoine, 755571 Paris cedex 12, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, Centre Hospitalier Universitaire Saint-Antoine, 184, rue du Faubourg-Saint-Antoine, 755571 Paris cedex 12</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Cantagrel, Alain" sort="Cantagrel, Alain" uniqKey="Cantagrel A" first="Alain" last="Cantagrel">Alain Cantagrel</name><affiliation wicri:level="3"><nlm:affiliation>Service de Rhumatologie, Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9</wicri:regionArea><placeName><region type="region" nuts="2">Occitanie (région administrative)</region><region type="old region" nuts="2">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Claudepierre, Pascal" sort="Claudepierre, Pascal" uniqKey="Claudepierre P" first="Pascal" last="Claudepierre">Pascal Claudepierre</name><affiliation wicri:level="3"><nlm:affiliation>Service de Rhumatologie, Centre Hospitalier Universitaire Henri Mondor, 51 avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, Centre Hospitalier Universitaire Henri Mondor, 51 avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Créteil</settlement></placeName></affiliation></author><author><name sortKey="Debiais, Francoise" sort="Debiais, Francoise" uniqKey="Debiais F" first="Françoise" last="Debiais">Françoise Debiais</name><affiliation wicri:level="3"><nlm:affiliation>Service de Rhumatologie, Centre Hospitalier Universitaire, 2, rue de la Milétrie, BP 577, 86021 Poitiers cedex, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, Centre Hospitalier Universitaire, 2, rue de la Milétrie, BP 577, 86021 Poitiers cedex</wicri:regionArea><placeName><region type="region" nuts="2">Nouvelle-Aquitaine</region><region type="old region" nuts="2">Poitou-Charentes</region><settlement type="city">Poitiers</settlement></placeName></affiliation></author><author><name sortKey="Dieude, Philippe" sort="Dieude, Philippe" uniqKey="Dieude P" first="Philippe" last="Dieudé">Philippe Dieudé</name><affiliation wicri:level="3"><nlm:affiliation>Service de Rhumatologie, Groupe Hospitalier Universitaire Bichat-Claude Bernard, 46, rue Henri-Huchard, 75018 Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, Groupe Hospitalier Universitaire Bichat-Claude Bernard, 46, rue Henri-Huchard, 75018 Paris</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Goupille, Philippe" sort="Goupille, Philippe" uniqKey="Goupille P" first="Philippe" last="Goupille">Philippe Goupille</name><affiliation wicri:level="3"><nlm:affiliation>Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Tours, Hôpital Trousseau, 37044 Tours cedex 9, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Tours, Hôpital Trousseau, 37044 Tours cedex 9</wicri:regionArea><placeName><region type="region" nuts="2">Centre-Val de Loire</region><region type="old region" nuts="2">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation></author><author><name sortKey="Roux, Christian" sort="Roux, Christian" uniqKey="Roux C" first="Christian" last="Roux">Christian Roux</name><affiliation wicri:level="3"><nlm:affiliation>Service de Rhumatologie, Centre Hospitalier Universitaire Cochin, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, Centre Hospitalier Universitaire Cochin, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Schaeverbeke, Thierry" sort="Schaeverbeke, Thierry" uniqKey="Schaeverbeke T" first="Thierry" last="Schaeverbeke">Thierry Schaeverbeke</name><affiliation wicri:level="3"><nlm:affiliation>Centre Hospitalier Universitaire de Bordeaux, FHU ACRONIM, place Amélie-Raba-Léon, 33076 Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Centre Hospitalier Universitaire de Bordeaux, FHU ACRONIM, place Amélie-Raba-Léon, 33076 Bordeaux</wicri:regionArea><placeName><region type="region" nuts="2">Nouvelle-Aquitaine</region><region type="old region" nuts="2">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Wendling, Daniel" sort="Wendling, Daniel" uniqKey="Wendling D" first="Daniel" last="Wendling">Daniel Wendling</name><affiliation wicri:level="3"><nlm:affiliation>Service de Rhumatologie, Centre Hospitalier Universitaire Jean-Minjoz, 1, boulevard Fleming, 25030 Besançon cedex, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, Centre Hospitalier Universitaire Jean-Minjoz, 1, boulevard Fleming, 25030 Besançon cedex</wicri:regionArea><placeName><region type="region" nuts="2">Bourgogne-Franche-Comté</region><region type="old region" nuts="2">Franche-Comté</region><settlement type="city">Besançon</settlement></placeName></affiliation></author><author><name sortKey="Pham, Thao" sort="Pham, Thao" uniqKey="Pham T" first="Thao" last="Pham">Thao Pham</name><affiliation wicri:level="3"><nlm:affiliation>Service de Rhumatologie, Centre Hospitalier Universitaire Sainte Marguerite, 270, boulevard de Sainte-Marguerite, 13274 Marseille cedex 9, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, Centre Hospitalier Universitaire Sainte Marguerite, 270, boulevard de Sainte-Marguerite, 13274 Marseille cedex 9</wicri:regionArea><placeName><region type="region" nuts="2">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement></placeName></affiliation></author><author><name sortKey="Thomas, Thierry" sort="Thomas, Thierry" uniqKey="Thomas T" first="Thierry" last="Thomas">Thierry Thomas</name><affiliation wicri:level="3"><nlm:affiliation>Department of Rheumatology, Hôpital Nord, CHU Saint-Étienne, Inserm U1059, Université de Lyon-Université Jean-Monnet, Saint-Étienne, France. Electronic address: thierry.thomas@chuse.fr.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Rheumatology, Hôpital Nord, CHU Saint-Étienne, Inserm U1059, Université de Lyon-Université Jean-Monnet, Saint-Étienne</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Saint-Étienne</settlement></placeName></affiliation></author></analytic><series><title level="j">Joint bone spine</title><idno type="eISSN">1778-7254</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Rheumatologists must contend with COVID-19 pandemic in the management of their patients and many questions have been raised on the use of both anti-inflammatory drugs and disease-modifying anti-rheumatic drugs (DMARD). The French Society of Rheumatology (SFR) selected the most critical ones to the daily practice of a rheumatologist and a group of 10 experts from SFR and Club Rheumatism and Inflammation (CRI) boards proposed responses based on the current knowledge of May 2020.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Following the availability of the first 18 questions and statements, 1400 individuals consulted the frequently asked questions between the March 31, 2020 and April 12, 2020. As a result, 16 additional questions were forwarded to the SFR, and answered by the board. An additional round of review by email and video conference was organized, which included updates of the previous statements. The scientific relevance of 5 of the questions led to their inclusion in this document. Each response received a final assessment on a scale of 0-10 with 0 meaning no agreement whatsoever and 10 being in complete agreement. The mean values of these votes for each question are presented as the levels of agreement (LoA) at the end of each response. This document was last updated on April 17, 2020.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Based on current scientific literature already published, in most circumstances, there is no contraindication to the initiation or continuation of anti-inflammatory drugs as well as DMARDs. If signs suggestive of infection (coronavirus or other) occur, treatments should be discontinued and resumed, if necessary, after 2 weeks without any symptoms. Only, some signals suggest that people taking an immunosuppressive dose of corticosteroid therapy are at greater risk of developing severe COVID-19. Intra-articular injections of glucocorticoids are allowed when there is no reasonable therapeutic alternative, and providing that precautions to protect the patient and the practitioner from viral contamination are adopted, included appropriate information to the patient.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Currently available data on managing patients with rheumatic diseases during the COVID-19 pandemic are reassuring and support continuing or initiating symptomatic as well as specific treatments of these diseases, the main target of their management remaining their appropriate control, even during this pandemic.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32473418</PMID><DateRevised><Year>2020</Year><Month>09</Month><Day>09</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1778-7254</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>May</Month><Day>27</Day></PubDate></JournalIssue><Title>Joint bone spine</Title><ISOAbbreviation>Joint Bone Spine</ISOAbbreviation></Journal><ArticleTitle>Managing patients with rheumatic diseases during the COVID-19 pandemic: The French Society of Rheumatology answers to most frequently asked questions up to May 2020.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">S1297-319X(20)30092-0</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.jbspin.2020.05.006</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Rheumatologists must contend with COVID-19 pandemic in the management of their patients and many questions have been raised on the use of both anti-inflammatory drugs and disease-modifying anti-rheumatic drugs (DMARD). The French Society of Rheumatology (SFR) selected the most critical ones to the daily practice of a rheumatologist and a group of 10 experts from SFR and Club Rheumatism and Inflammation (CRI) boards proposed responses based on the current knowledge of May 2020.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Following the availability of the first 18 questions and statements, 1400 individuals consulted the frequently asked questions between the March 31, 2020 and April 12, 2020. As a result, 16 additional questions were forwarded to the SFR, and answered by the board. An additional round of review by email and video conference was organized, which included updates of the previous statements. The scientific relevance of 5 of the questions led to their inclusion in this document. Each response received a final assessment on a scale of 0-10 with 0 meaning no agreement whatsoever and 10 being in complete agreement. The mean values of these votes for each question are presented as the levels of agreement (LoA) at the end of each response. This document was last updated on April 17, 2020.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Based on current scientific literature already published, in most circumstances, there is no contraindication to the initiation or continuation of anti-inflammatory drugs as well as DMARDs. If signs suggestive of infection (coronavirus or other) occur, treatments should be discontinued and resumed, if necessary, after 2 weeks without any symptoms. Only, some signals suggest that people taking an immunosuppressive dose of corticosteroid therapy are at greater risk of developing severe COVID-19. Intra-articular injections of glucocorticoids are allowed when there is no reasonable therapeutic alternative, and providing that precautions to protect the patient and the practitioner from viral contamination are adopted, included appropriate information to the patient.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Currently available data on managing patients with rheumatic diseases during the COVID-19 pandemic are reassuring and support continuing or initiating symptomatic as well as specific treatments of these diseases, the main target of their management remaining their appropriate control, even during this pandemic.</AbstractText><CopyrightInformation>Copyright © 2020 Société française de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Richez</LastName><ForeName>Christophe</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Centre Hospitalier Universitaire de Bordeaux, FHU ACRONIM, place Amélie-Raba-Léon, 33076 Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Flipo</LastName><ForeName>René-Marc</ForeName><Initials>RM</Initials><AffiliationInfo><Affiliation>Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Lille, Hôpital Roger Salengro, rue du Professeur-Emile-Laine, 59037 Lille cedex, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Berenbaum</LastName><ForeName>Francis</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Service de Rhumatologie, Centre Hospitalier Universitaire Saint-Antoine, 184, rue du Faubourg-Saint-Antoine, 755571 Paris cedex 12, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cantagrel</LastName><ForeName>Alain</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Service de Rhumatologie, Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Claudepierre</LastName><ForeName>Pascal</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Service de Rhumatologie, Centre Hospitalier Universitaire Henri Mondor, 51 avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Debiais</LastName><ForeName>Françoise</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Service de Rhumatologie, Centre Hospitalier Universitaire, 2, rue de la Milétrie, BP 577, 86021 Poitiers cedex, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dieudé</LastName><ForeName>Philippe</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Service de Rhumatologie, Groupe Hospitalier Universitaire Bichat-Claude Bernard, 46, rue Henri-Huchard, 75018 Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Goupille</LastName><ForeName>Philippe</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Tours, Hôpital Trousseau, 37044 Tours cedex 9, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Roux</LastName><ForeName>Christian</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Service de Rhumatologie, Centre Hospitalier Universitaire Cochin, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schaeverbeke</LastName><ForeName>Thierry</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Centre Hospitalier Universitaire de Bordeaux, FHU ACRONIM, place Amélie-Raba-Léon, 33076 Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wendling</LastName><ForeName>Daniel</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Service de Rhumatologie, Centre Hospitalier Universitaire Jean-Minjoz, 1, boulevard Fleming, 25030 Besançon cedex, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pham</LastName><ForeName>Thao</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Service de Rhumatologie, Centre Hospitalier Universitaire Sainte Marguerite, 270, boulevard de Sainte-Marguerite, 13274 Marseille cedex 9, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Thomas</LastName><ForeName>Thierry</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Rheumatology, Hôpital Nord, CHU Saint-Étienne, Inserm U1059, Université de Lyon-Université Jean-Monnet, Saint-Étienne, France. Electronic address: thierry.thomas@chuse.fr.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>05</Month><Day>27</Day></ArticleDate></Article><MedlineJournalInfo><Country>France</Country><MedlineTA>Joint Bone Spine</MedlineTA><NlmUniqueID>100938016</NlmUniqueID><ISSNLinking>1297-319X</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">Health system</Keyword><Keyword MajorTopicYN="N">Inflammatory rheumatic diseases</Keyword><Keyword MajorTopicYN="N">Treatment</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>05</Month><Day>05</Day></PubMedPubDate><PubMedPubDate 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