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COVID Breakthrough Infections in Rheumatic Patients

Jack Cush, MD

Analysis of records from the Mass General Brigham healthcare system in the Boston area, shows that breakthrough infections (after receiving SARS-CoV-2 vaccines) in patients with systemic autoimmune rheumatic diseases (SARDs) are not uncommon, and may be severe or fatal.

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RheumNow Podcast – COVID Marching Amidst the Madness (8.27.2021)

Jack Cush, MD

We have a lot of news, information and approvals to review and discuss, though I need to begin with what's weighing heavily on my mind. After, we'll dive into what we learned this week.

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RheumNow Podcast – Booster Shots for COVID (8.13.2021)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.

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Two cohorts from the Nurses’ Health Study (1984–2014 & 1991–2013) showed no association between diet & increased risk of incident #SLE; but that a high nut/legume diet may be associated with a reduced SLE risk https://t.co/mbBs7KZA6A

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Dr. John Cush RheumNow ( View Tweet)

ICYMI: Using inpatient hospital records of 1.9 million SLE pts, the mortality of hospitalized #SLE changed little from 2006-2016;mortality dropped from 2.2% to 1.5% - with most of this decline between 2006-‘08 and no change since. Racial disparities seen. https://t.co/UUsJYFxQS4

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Dr. John Cush RheumNow ( View Tweet)

Using inpatient hospital records of 1.9 million SLE pts, the mortality of hospitalized #SLE changed little from 2006-2016; mortality dropped from 2.2% to 1.5% - with most of this decline between 2006-2008 and no change since. Racial disparities seen. https://t.co/UUsJYFxQS4

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Dr. John Cush RheumNow ( View Tweet)

Multi-center study of 215 pediatric SLE patients - 55%(118) w/ Hematologic findings: most common anemia (88), hemolytic anemia (4). Signif assoc w/ HEME dz: Renal Dz, low C3, APL Abs, anti-β2 GP1, Sm, LAC, high SLEDAI. Most Rx w/ steroids, IVIG or RTX https://t.co/nuD524kkD4 https://t.co/6a14bQ6SQ6

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Dr. John Cush RheumNow ( View Tweet)
Watch: Drs. Jack Cush, Kathryn Dao ( @KDAO2011) , Janet Pope ( @Janetbirdope) Eric Dein ( @ericdeinmd) and Yuz Yusof discuss a number of lupus presentations presented at the virtual EULAR 2021 meeting. #RheumNow https://t.co/yUEXTOatpR

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Dr. John Cush RheumNow ( View Tweet)

NIAID will study COVID‐19 Booster Vaccine in Autoimmune Disease Non‐Responders (including MS, RA, SLE, Scleroderma,pemphigus); 20 sites, 600 pts (taking MTX, MMF or RTX) w/ poor resp to mRNA vax & recv 3rd booster vax. https://t.co/YwCvGnX21F https://t.co/th2WoRv1ng

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Dr. John Cush RheumNow ( View Tweet)

Swedish study of 287 SLE pts shows rare risk of autoimmune liver disease. While 14% had persistent LFTs, only 2.8% dx w/ autoimmune hepatitis. 1.4-2.1% met criteria for primary biliary cholangitis. Both AIH & PBC AIH are overrepresented in SLE https://t.co/oc5SLJtycf

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Dr. John Cush RheumNow ( View Tweet)

Brazilian national study of 319 SLE & 251,800 nonSLE pts hospitalized with COVID-19 showed that SLE increases risk of death (RR 1.74) & poor outcomeS (RR 1.39). Having lupus doubled (RR 2.2) the risk of risk of death. https://t.co/8VJjdOEuzS

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Dr. John Cush RheumNow ( View Tweet)

Among pregnant women, receipt of the BNT162b2 vaccine was associated with a 78% lower risk of incident SARS-CoV-2 infection. Cohort study tincluded 15 060 pregnant women in Israel. No adverse pregnancy outcome difference in Vax Pts https://t.co/jXUjaKIfUV

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Dr. John Cush RheumNow ( View Tweet)

Rheums--have a question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/wzNmOzH4VE https://t.co/QJn6Uo3lbM

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Dr. John Cush RheumNow ( View Tweet)
Comprehensive, full read overview of (European EADV) S2k guideline: Diagnosis and management of cutaneous lupus erythematosus – Part 1 (classification, Dx, activity) & Part 2 (Treatment) https://t.co/puBCr8VO1I https://t.co/rZKDEsvDzr

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Dr. John Cush RheumNow ( View Tweet)

The CDC has reported that mRNA vaccine effectiveness against COVID-19–associated hospitalizations was sustained over 24 weeks; but there is evidence of waning protection amongst the immunosuppressed. https://t.co/UpQjFgKTpE https://t.co/3dQ2jacwJD

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Dr. John Cush RheumNow ( View Tweet)
ICYMI: Belimumab in Pregnancy? a study of 13 pregnancies in 13 pts, mean age 38 yrs.. There were 11 live births, 1 case omphalitis (recovered w Abx) . No fetal anomalies found. 6 pts (46%) w/ Hx of recurrent pregnancy loss, four had live births on BEL https://t.co/FJJhepa25M

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Dr. John Cush RheumNow ( View Tweet)

Important read re:G6PD testing prior to HCQ Rare & not assoc w/hemolytic anemia in this cohort, but only 11 pts with G6PDH deficiency I'm v. skeptical of G6PD screening; cost (no HCQ in SLE) could easily be worse than benefit (avoiding hemolytic anemia) Do you routinely test? https://t.co/HI2PuF1Xq9
Mike Putman EBRheum ( View Tweet)
Check for APAs and LAC in SLE pts with hemolytic anemia https://t.co/hlGfnq89Pz

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k dao KDAO2011 ( View Tweet)

Popular post-- AstraZeneca announced that anifrolumab (Saphnelo or anifrolumab-fnia) was approved by the the FDA for that treatment of adult patients with moderate to severe systemic lupus erythematosus (SLE) who are receiving standard therapy. https://t.co/22HVA32IAh https://t.co/CGkBW80un4

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Dr. John Cush RheumNow ( View Tweet)
Interesting case report of difficult periorbital Discoid lupus erythematosus (DLE) treated with topical tofacitinib, 2%, ointment, a topical Janus kinase (JAK) 1/3 inhibitor. https://t.co/NZxUFW9ilN

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Dr. John Cush RheumNow ( View Tweet)

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