P069 Results of an online survey exploring the effects of shielding during the COVID-19 pandemic on patients with spondyloarthritis (SpA)

Abstract

Background/Aims The COVID-19 pandemic has created many challenges for patients with chronic rheumatological diseases. SpA - which includes ankylosing spondylitis (AS), axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), and enteropathic arthritis - often affects young people who are otherwise fit and able. Many SpA patients take immunosuppressive medications and therefore were advised to shield. In view of this, we conducted a survey to better understand how shielding has affected the physical activity and symptoms of SpA patients during the pandemic. Methods An online anonymised survey was created and advertised via social media from 4th June to 4th July 2020. Patients with SpA were invited to complete the survey which included 18 questions exploring the impact of the pandemic on their symptoms, physical activity levels and medication use. Results There were 136 survey respondents, of whom 74.3% were female, with an age range from under 25 to over 75 years. The underlying diagnoses were PsA (60.5%), AS (28.4%), axSpA (10.5%) and enteropathic arthritis (0.8%). The majority (66.7%) of respondents were shielding; 44.1% were on disease modifying anti-rheumatic drugs (csDMARDs) and 56.6% were on biologics (bDMARDs). Most (94.1%) had continued their DMARDs throughout the shielding period. Non-steroidal anti-inflammatory drug (NSAID) use was reported to be increased in 18.6% of respondents, and unchanged in 69.0%. Compared to before the pandemic, 54.8% reported worsening joint stiffness and 45.6% reported worsening joint pain.Most respondents (67.6%) reported reduced levels of physical activity, the commonest reasons being: shielding (54.6%); increased fatigue (45.8%); concerns around social distancing (45.4%); poor sleep quality (38.6%); working from home (28.6%) and low mood (28.6%). Only 14.7% had attended a virtual exercise class. Conclusion Approximately 2 in 3 patients with SpA reported they were shielding during the first wave of the pandemic. Similar numbers of patients reported reduced physical activity levels and increased joint stiffness over this time. It is important to acknowledge that given the nature of the anonymised survey, we cannot be certain if the same patients who were shielding were the same as those who had reduced levels of physical activity or worsening symptoms. We have, however, shown that over half of the surveyed patients attributed their reduced physical activity levels to shielding. Taking into account that social restrictions (either self-imposed or government advised) are likely to be ongoing, we believe that a focus should be placed on supporting patients to maintain their activity levels, through initiatives such as specialist virtual exercise classes. Disclosure M. Naja: None. R. Amarnani: None. M. Castelino: None.