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What Worries You, Masters You (7.1.2022)

Jack Cush, MD

Dr. Jack Cush reviews recent news, regulatory and guideline updates from the past week on RheumNow.com.  Studies on methotrexate use, COVID vaccination, Supplements and vitamins, and arthrocentesis despite anticoagulation are discussed.

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Two Week Methotrexate Hold with COVID-19 Vaccination

Jack Cush, MD

A cohort study of rheumatoid arthritis (RA) patients evaluated immunogenicity of COVID vaccination with and without holding methotrexate (MTX) for and 2-weeks and showed better immunogenicity, but more RA flares with the second MTX withdrawal. 

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COVID Test Antibody

COVID-19 Death is Dependent on Age and Type I IFN Autoantibodies

Jack Cush, MD

A study in PNAS of has shown that autoantibodies against type I interferons (IFNs) are strong predictors of death from COVID-19.

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Kawasaki.jpg

What Happened to Kawasaki Disease During COVID-19?

Jack Cush, MD

During the COVID-19 pandemic, a new COVID-related syndrome in children, the "Multisystem inflammatory syndrome in children" (MIS), was described as being similar to but distinctly different than childhood Kawasaki's disease (KD). A new epidemiologic report shows that while MIS-C cases rose, KD cases fell and remained low during the period of masking and school closure.

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covid coronavirus virus

Spondyloarthritis and COVID-19

Robert Chao, MD

There are still questions surrounding COVID-19, and some common questions I receive from patients revolve around what to do with their current DMARDs or should they even start treatment during this pandemic. Two studies focused on this question. 

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The Safety of Rituximab and JAK Inhibitors with post-COVID Vaccination

Md Yuzaiful Md Yusof, MRCP(UK), PhD

At the onset of the pandemic, data from the Global Rheumatology Alliance reported increased risk of poor severe COVID outcomes including deaths in patients who were treated with rituximab and baricitinib. With the vaccination program undertaken globally, has this risk been attenuated?

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Patients in the COVID-19 Global Rheumatology Alliance were Surveyed; responses from 9300 Rheum Dz adults (RA 39%, SLE 31%) showed that 27% had a change in employment status during COVID (w/ 13.6% decrease in full-time employment) https://t.co/exi6KDmMGT https://t.co/fPl091rXdO

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Dr. John Cush RheumNow ( View Tweet)
Two Week MTX Hold with COVID-19 Vaccination A cohort study of RA patients evaluated immunogenicity of COVID vaccination with and without holding MTX for and 2-weeks and showed better immunogenicity, but more RA flares with the second MTX withdrawal. https://t.co/Kqa8Uy9tDm https://t.co/UvMHo8xAw8

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Dr. John Cush RheumNow ( View Tweet)
COVID-19 Death is Dependent on Age and Type I IFN Autoantibodies https://t.co/WrWujgHoA4 https://t.co/NTwUeXHYKr

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Dr. John Cush RheumNow ( View Tweet)
COVID-19 hospitalization among Medicare diabled was ~50% higher (3,148/100k) than age matched pop. , and hospitalization rates increased with age in both groups. Among the disabled, American Indian or Alaska Natives had highest rate https://t.co/Xa4NlalHdf https://t.co/dP0c3ajQAW

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Dr. John Cush RheumNow ( View Tweet)
Review on reactive arthritis & COVID: 22 articles , 25 pts (14M:11F), age 45 yrs. Oligoarthritis was most common. Onset (COVID to arthritis) was 6-48 days. Steroids in 13, 2 w/ SSZ, Sxs improved 22/25, mean resolution was 16 +/- 57 days https://t.co/0YABcjz9Gk https://t.co/W5Vnn1NjkD

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Dr. John Cush RheumNow ( View Tweet)
Spondyloarthritis and COVID-19 With the availability of vaccines and new therapeutics, many of our patients are fully vaccinated. We know this can limit their chances of severe COVID all while allowing their rheumatic disease to be treated. #EULAR2022 https://t.co/PmQNKYg1Ao https://t.co/N4DJVYJqrL

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Dr. John Cush RheumNow ( View Tweet)
Biosimilars and COVID vaccines have made nocebo more pertinent than ever. How do we combat it? First line is good communication, and the foot soldiers are the right phrases. Language matters. #EULAR2022 @RheumNow https://t.co/U0Chv9ia1G
David Liew drdavidliew ( View Tweet)
Rituximab/belimumab patients & COVID vaccination response: may have had average antibody response but there’s still the cellular response to consider too! Not as bad. Still caution++, but when ritux really needed we’ll find a way despite COVID from roundup #EULAR2022 @RheumNow https://t.co/zFr6QI9TOG
David Liew drdavidliew ( View Tweet)
Sreekanth et al. 2 studies re holding MTX after both doses vs only 2nd dose of AZ COVID vaccine. Either holding strategy increased ab titres. Only holding 2nd non-inferior to holding both with decreased flares @RheumNow #EULAR2022 LB0003 https://t.co/aCOEdXp4ol https://t.co/XAZyBojryK

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Richard Conway RichardPAConway ( View Tweet)
#EULAR2022 LB0006 SAPHYR: P3 trial, 52 wk: Sarilumab in relapsing PMR Study terminated early due to COVID recruitment ⭐️Sustained remission: 28 vs 10%, primary endpt ⭐️HR of flare 0.56 on Sarilumab ⭐️Less steroid usage, glucocorticoid tox score @Rheumnow https://t.co/5PP1YP7YtU
Eric Dein ericdeinmd ( View Tweet)
#LB0006 #EULAR2022 Therapy for relapsing polymyalgia rheumatica. 118/280 recruited re:COVID impact. Phase 3 RCT of Sarilumab+14Wk Steroid taper showed more pts had sustained remission at Wk52 vs PBO+52Wk Steroid Taper(28% vs 10%) even if CRP excluded. PRO improved too! @RheumNow https://t.co/P11iXIAfGn
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2022 LB003: W/d MTX w COVID vax MIVAC 1: hold MTX both vax vs continuing MIVAC 2: hold after 2nd dose only vs continuing ⭐️MTX hold: improved Ab titers, no diff in MIVAC1/2 ⭐️Higher reported flare for holding with both doses (36%) vs just 2nd dose (12%) @Rheumnow

Eric Dein ericdeinmd ( View Tweet)

#POS1236 #EULAR2022 More data to justify safety of #COVID vaccination to our #lupus patients. A study in Italy (>450 pts) found 1/4 had side effects (mostly mild) and 4% had a flare. These side effects were more common in those on >1 DMARDS and Belimumab @RheumNow https://t.co/mNS6rQfsSq
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Please see my short video on Promising Safety Outlook for Rituximab and Baricitinib in Vaccinated Patients #EULAR2022 @RheumNow https://t.co/bqzdWIzoOg

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)

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