Rheumatology

Dear Rheumatology Patient,

(A) Important information about new treatments for coronavirus

The NHS is using new treatments for coronavirus. You might be suitable for these treatments if a PCR test confirms that you have coronavirus.

These treatments need to be given quickly after you start to feel unwell. They can help to stop you from getting seriously ill from coronavirus.

More information about these treatments is available at www.nhs.uk/CoronavirusTreatments

This letter has specific instructions for patients who have been identified by a specialist team as potentially being able to benefit from COVID treatments. Please ignore this letter if you have already been contacted by NHS England.

You should:

1. Have a PCR test kit ready at home
2. Take a PCR test if you get coronavirus symptoms
3. If the PCR test confirms that you have coronavirus: call your GP practice or 111 so they can refer you for potential treatment.

Coronavirus treatments can help you if you are ill but vaccination is still the best protection for you and your loved ones. You can find more information at www.nhs.uk/covidvaccine.

1. Have a PCR test kit ready at home

You are strongly encouraged to keep a PCR test kit at home so you can get tested for coronavirus quickly after any symptoms. This will help you get treated more quickly.

Please call 119, selecting the option for Test & Trace, to request a PCR test to keep at home, noting you may be eligible for COVID treatments. You can use 119 to request a replacement PCR test at any time.

You can also request a PCR test kit to keep at home by going online at https://www.gov.uk/get-coronavirus-test. When answering the question, ‘Why are you asking for a test?’, select ‘I’ve been told to get a test by my local council, health protection team or healthcare professional’, and then select ‘A GP or other healthcare professional has asked me to get a test’.

2. Take a PCR test if you get coronavirus symptoms

Use your PCR test kit as soon as possible if you develop any of these coronavirus symptoms, even if they are mild:

a high temperature

a new, continuous cough (coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours)

a loss or change to your sense of smell or taste

If you get coronavirus symptoms and don’t have a PCR test kit at home, you can still get a PCR test by phoning 119 or visiting https://www.gov.uk/get-coronavirus-test

Follow the PCR test instructions to register and send it back to Test & Trace.

When registering a PCR test, it is very important that you enter your NHS number and postcode correctly. This lets you get your test result and helps the NHS to contact you about treatment if you have coronavirus.

3. If the PCR test confirms that you have coronavirus

Following a positive PCR test, most patients will be contacted by a local NHS coronavirus medicines team to assess whether they might benefit from treatments.

However, some patients including you might not be contacted.

If you test positive after a PCR test you must contact your GP practice or call 111 who can make a referral.

Your specialist team can also make a referral if necessary.

These treatments will only be available from the NHS and will not cost you anything. The NHS will never ask you for your bank account details or to pay for treatment.

Why have you contacted me?

Health experts have looked at the health conditions which put people more at risk of coronavirus. This has been agreed by the UK chief medical officers.

Your medical records indicate that you might currently have, or have previously had, one or more of those health conditions, which means that these new treatments might be suitable for you if you ever test positive for coronavirus through a PCR test.

More information is available at www.nhs.uk/CoronavirusTreatments

Easy read and other language versions of this information are available from https://www.england.nhs.uk/coronavirus/treatments

 

(B) Update: timing of additional COVID-19 booster vaccine dose (4^th vaccination) for those eligible for a 3^rd primary dose

In response to the Omicron variant the JCVI (Joint Committee on Vaccination and Immunisation) announced on 29th November 2021 that patients who have received a third primary dose of the COVID-19 vaccine should be offered a booster (4^th dose) with a minimum of 3 months between the third primary and booster dose.

Those who have not yet received their third primary dose may be given the third dose now to avoid further delay (a minimum of 8 weeks is required between 2^nd and 3^rd primary doses).

Information on who is eligible for 3^rd primary dose can be found here: https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/coronavirus-vaccine-3rd-dose/

Reminder for patients receiving Rituximab treatment

You should aim to have your COVID 19 booster either:

• At least 2 weeks before your Rituximab infusion

OR

• At least 4 weeks after your Rituximab infusion

More information on Covid vaccination for rheumatology patients can be found here: https://www.versusarthritis.org/covid-19-updates/vaccines-for-covid-19-your-questions-answered/

Please stay safe.

Best wishes for the festive season from us all in the Rheumatology Department

Dr Kelsey M Jordan, Clinical Lead for Rheumatology

Dear Rheumatology Patient

JCVI guidance for vaccinating immunosuppressed individuals with a third primary dose

We are writing to let you know that you are eligible for a supplementary dose of the COVID-19 vaccine in light of the latest advice from the Joint Committee on Vaccination and Immunisation (JCVI). The advice recommends a third dose for individuals aged 12 years and over taking immunosuppressive treatment now or when they had the 1^st and/or 2^nd COVID vaccination.

You are eligible within this category given your current health condition requiring immune suppressant medications. This advice is a precautionary measure to increase your immunity level and provide a better vaccine response based on relevant studies and experience with other vaccines. This will form part of your primary course of vaccination and is separate to a booster vaccination.

It is recommended your 3^rd vaccination is at least 8 weeks after your 2^nd vaccination. A booster is likely to be recommended 6 months’ after your 3^rd vaccination. If you have already had your booster or due your booster, this will be considered as your 3^rd vaccination.

We recommend that you use the national booking system at www.nhs.uk/covid-vaccination  or call 119 free of charge to book your vaccination. Please book this dose as a Booster dose on the national booking system. This will later be changed to a third dose on the system. You should also take this letter with you to your appointment as additional proof of your eligibility.

If you have any questions, please get in touch with either your GP or consultant team to discuss further.

For more information about the coronavirus vaccine, visit www.nhs.uk/covid-vaccination.

Yours sincerely,

Dr Kelsey M Jordan

Consultant Rheumatologist & Honorary Senior Lecturer

Clinical Lead for Rheumatology UH Sussex (East)

Disease Modifying Drugs (DMARDs):

Azathioprine; Ciclosporin; Cyclophosphamide; Leflunomide; Methotrexate; Mycophenolate mofetil; Tacrolimus

(Please note Sulfasalazine and Hydroxychloroquine are not immune suppressant and do not qualify for a 3^rd primary vaccination)

Biological Treatments

Co-stimulatory molecules: Abatacept;

TNF inhibitors: Adalimumab (Amgevita, Humira, Hyrimoz, Imraldi); Certolizumab; Etanercept (Benepali, Enbrel); Golimumab; Infliximab

Interleukin-1 inhibitors: Anakinra; Canakinumab

Interleukin-6 inhibitors: Tocilzumab; Sarilumab

Interleukin-17/23 inhibitors: Ustekinumab; Secukinumab; Ixekizumab; Brodalumab; Guselkumab and Tildrakizumab

CD20 inhibitors: Rituximab; Ocrelizumab

Janus Kinase Inhibitors: Baricitinib; Filgotinib; Tofacitinib; Upadacitinib