Why people living with autoimmune and inflammatory conditions need our attention now more than ever

It’s hard to believe that the COVID-19 pandemic started more than two years ago. The time since the first lockdowns were put into effect around the world has flown by, yet our fast-paced lives suddenly grinding to a halt somehow also feels like a lifetime ago. When I reflect on this, alongside the unprecedented challenges that we all faced (and which many around the world continue to navigate), given my role at Pfizer I can’t help but also think specifically of the difficulties for people suffering from autoimmune and inflammatory conditions.

The pandemic has impacted all aspects of healthcare systems to a level we could never have foreseen, and the consequences for patients have been innumerable and often tragic. Those who have fallen down the priority list due to being deemed ‘non-urgent’ are among those impacted– and people with chronic autoimmune and inflammatory conditions often fell into this category. The challenges presented by COVID-19 for people living with these conditions, such as mental health, disparities, and delays, existed across the entire patient journey – from prevention and self-care all the way through to diagnosis, treatment, and management.

More than two years on, now is the time to reprioritise these patients and address their unmet needs.

Reducing delays in diagnosis and treatment by harnessing telehealth

Healthcare restrictions during the pandemic meant that people with autoimmune and inflammatory conditions often endured delayed diagnoses or were unable to receive the regular check-ups and treatment they required to manage their conditions. For people living with irritable bowel disease (IBD), for example, this had significant consequences – with 1 in 5 people living with the condition experiencing flareups as they were unable to access the health services they needed.[1]

Telehealth may offer a solution for healthcare professionals to efficiently prioritise individuals who need face to face appointments and allow for more timely diagnosis and better management of these conditions. Prioritising the rollout of telehealth is crucial to alleviate the challenges that individuals with autoimmune and inflammatory conditions are currently facing due to a backlog of appointments.

Prioritising mental health

The heightened stress and anxiety of lockdowns and health concerns also contributed to a rise in flareups for many people living with these conditions, and techniques for managing their mental wellbeing were also restricted. In a global study of people with psoriasis,?42.7%?reported that their psoriasis symptoms worsened during the pandemic - those who indicated that their condition had worsened also had a greater likelihood of reporting symptoms of anxiety or depression.[2]

Supporting individuals holistically to manage not only their physical health, but also their mental and emotional health, is key to lessening the burden of these debilitating and often isolating chronic conditions. We worked with Dr. Laurie Keefer, a psychologist specialising in inflammation, to develop these?tips to support those living with chronic inflammatory conditions, such as ulcerative colitis, during COVID-19.

Tackling health inequalities

The pandemic also brought to light the significant healthcare disparities within and between countries, minority ethnic groups and other underserved populations, such as people who live in remote areas or lower socio-economic groups. For autoimmune and inflammatory conditions, healthcare disparities significantly limit the extent to which these diseases are understood and diagnosed in diverse populations. Atopic dermatitis, for example, is more prevalent in Black and Asian individuals [3], but they continue to be underrepresented in clinical trials. We must work together to ensure that care and treatment meet the needs of all ethnic groups. At Pfizer, we have a Diversity in Clinical Trials Center of Excellence, as well as several other initiatives to ensure the research we are doing reflects the people who will benefit from it – from ensuring patients in our trials have access to clinical data to build trust, to using telemedicine approaches to run trials remotely to increase access.

Prioritising innovation in I&I

In the autoimmune and inflammatory space, where many conditions, such as vitiligo, alopecia, and atopic dermatitis, remain overlooked, difficult to treat, and poorly understood, innovation and collaboration must be prioritised. The breathtakingly fast rollout of the COVID-19 vaccine demonstrated what is possible when there is an urgent unmet need. We too can learn from this drive and ambition to create a landscape in which breakthrough treatments can land in the hands of patients with chronic diseases as fast as innovation will allow.

Whilst there are many aspects of the pandemic that I hope we can leave behind, the innovation seen in the healthcare landscape over the last two years is not one of them. I hope that in years to come, we continue to use the lessons we learnt to strive for a more equitable, resilient, and innovative healthcare model for people living with autoimmune and inflammatory conditions and beyond.

References:

[1] Crohn’s and Colitis UK: https://crohnsandcolitis.org.uk/news-stories/news-items/life-in-lockdown-how-health-services-been-impacted.

[2] European Academy of Dermatology and Venereology: https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.17450.

[3] Experimental Dermatology: https://onlinelibrary.wiley.com/doi/10.1111/exd.13514.