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COVID-19: Identifying high-risk patients in England

The British Society for Rheumatology have issued guidance on identifying high-risk patients in England taking immunosuppressive medication.  The guide can be read here

The categories are as follows:

  • Definite High risk – to be advised to self-isolate
  • Moderate risk – self-isolation only if other concerns or high-risk circumstances
  • Low risk – no need to self-isolate

The drugs in the guidance are:

Immunosuppressive medications: Azathioprine, leflunomide, methotrexate, Mycophenolate (mycophenolate mofetil or mycophenolic acid), ciclosporin, cyclophosphamide, tacrolimus, sirolimus.

It does NOT include Hydroxychloroquine or Sulphasalazine either alone or in combination.

Biologic/monocolonal includes: Rituximab within last 12 months; all anti-TNF drugs (etanercept, adalimumab, infliximab, golimumab, certolizumab and biosimilar variants of all of these); Tociluzimab; Abatacept; Belimumab; Anakinra; Seukinumab; Ixekizumab; Ustekinumab; Sarilumumab; canakinumab

Small molecules includes: all JAK inhibitors – baracitinib, tofacitinib etc.

In all cases, if you are on these medications, for advice contact your prescribing doctor, and continue to follow the NHS 111 advice to reduce risk of contact with the virus.

British Society for Rheumatology
22 March 2020


Thanks for your question, we'll see what we can find out and post here.


Are the same guidelines being used in Scotland to identify the most vulnerable people in relation to immunosuppressant medication?

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