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Covid-19 Primary Care Resources

Rheumatology patients

Routine monitoring of DMARDs, and assessment/ treatment of suspected Covid-19 in patients on immunosuppressants

This information is sourced from the British Society for Rheumatology (BSR) and NICE:


  • Use of immunosuppressants (conventional or biological) is probably more relevant in defining risk rather than the underlying individual disease
  • Many patients are on more than one of these drugs, thus increasing their overall risk/vulnerability

Patients known or suspected to have Covid‑19:

  • May have atypical presentations if on immunosuppressant treatments (eg no fever, no CRP rise)
  • Should not suddenly stop steroids

DMARD monitoring during the Covid-19 pandemic:

  • Assess with each patient whether it is safe to increase the time interval between blood tests for drug monitoring, particularly if 3‑monthly blood tests have been stable for more than 2 years.
  • Patients starting a new DMARD should follow recommended blood monitoring guidelines. When this is not possible, they should contact the relevant specialist for advice

A guide for rheumatology patients can be found on the Versus Arthritis website

See also:

Guidance on steroid prescribing