Anti-Viral Treatments
Anti-viral treatments are currently available for the treatment of COVID-19 in people who are immunosuppressed.
Recommendations
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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.
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Patients with IBD should discuss the risks and benefits of anti-viral therapies with their treating physician.
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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.
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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.
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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.
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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.
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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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