Anti-viral treatments are currently available for the treatment of COVID-19 in people who are immunosuppressed.
Crohn's and Colitis Canada supports the availability of anti-viral treatments including monoclonal antibodies (e.g. Sotrovimab) and oral anti-viral treatments (e.g. nirmatrelvir/ritonavir, Paxlovid) for adult IBD patients who are immunosuppressed. These treatments are currently available in most provinces to people who are immunosuppressed, but availability criteria may differ from province to province.
Patients with IBD should discuss the risks and benefits of anti-viral therapies with their treating physician.
Most provinces require a positive PCR test for COVID-19 for a patient >18 years old to qualify for anti-viral treatment. We recommend that if an immunosuppressed adult or child with IBD develops symptoms, they contact local health authorities or COVID-19 testing centres to obtain a PCR test. Most provinces are allowing immunosuppressed people to get a PCR test, even if they aren’t available to other people. Anti-viral therapies should be administered soon after symptom onset or a positive PCR test, but the time period after symptom onset varies by region, and criteria to qualify for anti-viral treatments differ across Canada.
Crohn's and Colitis Canada strongly recommends anti-viral therapy in IBD patients who are taking systemic steroids (prednisone, methylprednisolone, hydrocortisone) at a dose of >20 mg per day or >0.5 mg/kg/day in children. Anti-viral therapy is currently only approved for people >18 years. However, in children this therapy may be approved by a infectious disease specialist.
Crohn's and Colitis Canada also strongly recommends anti-viral therapy in adult IBD patients using immunosuppressive medications if they are unvaccinated or IBD patients who received their last vaccine >6 months ago.
IBD patients should speak to their treating physician about their other risk factors for severe COVID-19 (e.g. older age, having other health conditions) that might result in a physician recommending anti-viral therapies.
Vaccination with at least 3 doses of COVID-19 vaccine remains the most effective therapy to prevent severe COVID-19 (including hospitalization and death). Treatment with anti-viral therapies does not replace getting vaccinated.
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