Tocilizumab and Drug Shortage Headaches
Sep 22, 2021
Recent News
Read ArticleDo you know what’s in short supply? Trust, pediatric rheumatologists, and drugs. Since the onset of the pandemic, numerous drug shortages have affected rheumatology, including sulfasalazine, hydroxychloroquine, and now, tocilizumab.
IL-6 Inhibition in Refractory Systemic Sclerosis
Sep 22, 2021
A small, single-center cohort analysis of difficult, refractory systemic sclerosis (SSc) patients showed that treatment with tocilizumab (TCZ), an interleukin-6 inhibitor, resulted in significant improvement in joint and skin involvement, regardless of SSc disease duration or subtype.
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Dr. Calabrese shares his Delta COVID-19 breakthrough story on the blog today.
https://t.co/timjB2YPys https://t.co/6w6eQncQ8Z
Links:
Dr. John Cush @RheumNow ( View Tweet)
Sep 22, 2021
FDA approves Jakafi for chronic GVHD. Ruxolitinib (Jakafi, Incyte), an oral Janus kinase 1/2 inhibitor, previously received approval for treatment of patients aged 12 years or older with steroid-refractory acute GVHD. https://t.co/isItDebNZ8
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Dr. John Cush @RheumNow ( View Tweet)
Sep 22, 2021
Insurance data (biologics only given to refractory pts) study of 249 (TKR) & 159 (THR) surgeries in ~6000 #RA pts. Pts on biologics had signif less TKR (aHR: 0.55) & THR (0.63) vs higher rates if on MTX, steroids, biologic switch or APL syndr https://t.co/4rwuYswqz7
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Dr. John Cush @RheumNow ( View Tweet)
Sep 22, 2021
Retrosp. review of 10–24 yr olds w/ newly Dx #SLE shows 78% given steroid-sparing DMARDs by year 1; Most (69%) given HCQ & fewer (34%) given other immunosuppressants. Adults less likely to recv immDMARDs @1 yr https://t.co/aLi6FXlMd3
Links:
Dr. John Cush @RheumNow ( View Tweet)
Sep 22, 2021
VAMC case controlled study shows CPPD pts have nohigher risk for MACE. 23,124 CPPD vs 86,629 non-CPPD, w/ >250,000 Pt-Yrs FU. CPPD MACE risk not increased (HR 0.98), but there was incr risk of MI, CVA & acute coronary syndr. https://t.co/pgmZBxTg9O
Conclusions
Links:
Dr. John Cush @RheumNow ( View Tweet)
Sep 22, 2021
Prospective study of 77 RA patients in remission --> vax w/ BNT162b2 (BioNTech-Pfizer) (w/ temp D/C of DMARDs per ACR) found a vaccine-related flare rate of 7/8% (6 pts) w/ 5/6 flares after 2nd dose (2.6 days), resolved w/in 2 wks https://t.co/YOL3YVS2ne
Links:
Dr. John Cush @RheumNow ( View Tweet)
Sep 22, 2021
High Comorbidity Rates with Inclusion Body Myositis
Sep 21, 2021
Inclusion body myositis (IBM) patients tend to be older than those with idiopathic inflammatory myositis (IIM), but the scope of disease beyond their myositis is not appreciated. Now, a population-based, case-control study suggests both a lower overall survival and high comorbidity burden in IBM patients.
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Regarding Pfizer 1133 tofacitinib Safety study and recent FDA JAKi warnings -- Dr. Roy Fleischmann has said, "“There is a small increase in risk,” “But is it clinically meaningful?”, Read full interview here https://t.co/2Wd5h69Dfq
Links:
Dr. John Cush @RheumNow ( View Tweet)
Sep 21, 2021
MMWR reports real world vax efficacy in 3,689 adults (21 states) found better results w/ Moderna (93%) than Pfizer (88%) than Janssen (71%). 2 dose mRNA vaccines were more effective than 1 dose Janssen COVID vaccine https://t.co/phmPdB9dTW
Links:
Dr. John Cush @RheumNow ( View Tweet)
Sep 21, 2021
Lupus Research Alliance has awarded $3 million Global Team Science Awards to Drs Virginia Pascual (Weill Cornell Med Schoo) and Ignacio Sanz (Emory Univ Medial School) for their proposed collaborative, translational lupus projects. https://t.co/ecMlHiZfwe
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Dr. John Cush @RheumNow ( View Tweet)
Sep 21, 2021
Maker Trade name Generic
PFIZER Comirnaty Pfizer-BioNTech COVID-19 Vaccine FDA approved
MODERNA Spikevax Moderna COVID-19 Vaccine - EUA currently
J&J (pending) Janssen COVID-19 Vaccine- EUA currently
https://t.co/MM7XiSCczl
Links:
Dr. John Cush @RheumNow ( View Tweet)
Sep 21, 2021
Interested in becoming a rheumatologist? It’s interview season! Dr. Kathryn Dao (@KDAO2011 ) shares tips for the interviewer AND the candidate. #RheumNow #RheumTwitter
https://t.co/eWQs9CwqSm https://t.co/7FrkCWoAe8
Links:
Dr. John Cush @RheumNow ( View Tweet)
Sep 21, 2021
Worrisome Maternal Mortality with COVID-19 Infection
Sep 20, 2021
Maternal and fetal outcomes during the COVID-19 pandemic have not been well studied; yet a new retrospective study from Mexico indicates that during the pandemic maternal mortality increased by nearly 57%, with COVID-19 as the cause in 23% of cases.
This surveillance study examined maternal mortality was between February 2020–February 2021 in Mexico, with a focus on COVID-19 in pregnant women, and their outcomes.
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Addendum: Other conditions w/ a 1.2-2 fold higher risk of COVID death (admission) were CKD, hematologic cancer, epilepsy, COPD, CVD, stroke, atrial fibrillation, CHF, thromboembolism, PVD, type 2 diabetes. https://t.co/bbDsb1zLhX
Links:
Dr. John Cush @RheumNow ( View Tweet)
Sep 20, 2021
Addendum: COVID deaths increased w/ age, deprivation, male, Indian & Pakistanis. Highest risk w/ Down’s syndr (HR 12.7), renal transplant (8.1), sickle cell (7.7), Nursing home (4.1), chemotherapy (4.3), HIV/AIDS (3.3), liver cirrhosis (3), CNS dz (2.6) https://t.co/bbDsb1zLhX
Links:
Dr. John Cush @RheumNow ( View Tweet)
Sep 20, 2021
Breakthrough infections from UK QResarch database: Among 6.95 million vaccinated, 74.1% recv two vaccine doses, there were 2031 covid-19 deaths & 1929 hosp admissions; ~4.0% deaths & admissions were >14 days after 2nd dose https://t.co/bbDsb1zLhX
Links:
Dr. John Cush @RheumNow ( View Tweet)
Sep 20, 2021
Have you seen this download?
How to define difficult RA--download now.
https://t.co/6WGMEieHvK https://t.co/yYZdfyUQu0
Links:
Dr. John Cush @RheumNow ( View Tweet)
Sep 20, 2021
Claims case-controlled study shows statin use does not increase the risk of #RA - 32,726 RA and matched controls ; statin use (34 vs 32%) slightly increased RA risk (OR 1.12, 1.06–1.18), but signif lost after correcting for hyperlipidemia https://t.co/EcTlyE1MPx
Links:
Dr. John Cush @RheumNow ( View Tweet)
Sep 20, 2021
Analysis of existing #COVID data - as of 7/15/21, 114.9 million adults infected with COVID-19 in US. Overall population immunity (Infx+vax) is 62%, highest in adults >65yrs (77.2%); lowest in children <12 yrs (17.9%) https://t.co/EYiBUaQBLY
Links:
Dr. John Cush @RheumNow ( View Tweet)
Sep 20, 2021
From the blog
As many of you are aware, I have written and spoken on COVID-19 extensively over these past 20 months, and just last month wrote about the dangers of the delta variant. In July, things took an unexpected turn when I developed a breakthrough infection with the delta variant.
Recent Podcasts
- RheumNow Podcast – Do More DMARDs Mean More Switching? (9.17.2021)Sep 17, 2021
- RheumNow Podcast – Do More DMARDs Mean More Switching? (9.17.2021)Sep 17, 2021
- RheumNow Podcast – High Science and Future Treatments (9.10.2021)Sep 10, 2021
- Rheumatologist Views on new FDA JAK inhibitor Boxed WarningsSep 03, 2021
- RheumNow Podcast – JAK Inhibitor Warnings from the FDA (9.3.2021)Sep 03, 2021
Therapeutic Update
A Patient-Focused Approach to the Treatment of Rheumatoid Arthritis
Sponsored by AbbVie Medical Affairs
Sep 01, 2021
Do your patients with RA report persistent symptoms despite improved inflammatory markers? Listen to Dr. Wright discuss the importance of patient-focused measures and read about SELECT-COMPARE’s patient-driven data.
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