The corona pandemic is putting further pressure on healthcare: there is a threat of a major shortage of specific anti-inflammatories for severe forms of rheumatism. This can be stressful for rheumatic patients.
“Every time that medication is interrupted, there is a risk that the disease will become more active,” says Inger Meek, rheumatologist at Radboudumc and board member of the Dutch Association for Rheumatology. “And when that happens, it results in discomfort due to the pain and limitations and the risk of permanent damage to the joints. Any change in medication is therefore a very exciting period for a rheumatic patient.”
At the beginning of this year, it became clear that the rheumatoid drugs also work against slowing down corona infections in hospital patients. The World Health Organization (WHO) therefore advised doctors in July to use these agents to curb serious corona infections. The demand for these anti-inflammatories has since exploded worldwide.
The result is that there are now shortages everywhere. For patients with rheumatoid arthritis, these drugs are essential to prevent extensive damage to their joints. It is not uncommon for people to be unable to use their hands without these tools.
Upscaling is not an option
These are the anti-inflammatories tocilizumab and sarilumab, from pharmaceutical companies Roche and Sanofi. Scaling production in the short term is not an option, the companies say: they are complex agents that fight a protein (IL-6) in the human body to stop inflammation. The production of these medicines is very demanding and therefore cannot be outsourced to other manufacturers.
The pharmacies of Dutch hospitals now have a small stock. Corona patients therefore receive a lower but effective dose to use the drug as economically as possible.
“In principle, there is little or no stock available,” says Nicole Hunfeld. She is the hospital pharmacist for the Intensive Care Unit of Erasmus MC. As chair of the national Committee for Acute Medicines Shortages, she has an overview of the Dutch stocks.
–
