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Dr. Jack Cush discusses the news and recent journal reports from last weeks RheumNow.com, and answers viewer questions from #ACA - Ask Cush Anything.
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Putman et al has reported vaccine survey results from the COVID-19 Global Rheumatology Alliance (C19-GRA) in Lancet Rheumatology showing the uptake and vaccine hesitancy among people with rheumatic diseases (RMD).
Survey data from 7005 vaccinated and unvaccinated, adult RMD respondents from 102 countries was analyzed.
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A single dose of the monoclonal-antibody AZD7442 (combination of tixagevimab and cilgavimab) has been shown to be safe and effective as prophylaxis against COVID-19 infection in high risk individuals who tested positive for COVID-19.
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Dr. Jack Cush reviews the news and journal Reports from the past week on RheumNow.com - including fellowship COVID-19 concerns, the limits of T2T in gout and the real odds of RA remission with your first biologic.
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The incidence and mortality of cancer among autoimmune diseases (AID) was studied in a large Chinese cohort, demonstrating that while onset time and risks vary, there is an increased risk of malignancy in AID.
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Socioeconomic status (SES) often associates with poorer outcomes in systemic lupus erythematosus (SLE) patients; and a current study suggests this is unrelated to healthcare access issues.
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In a phase III trial, oral tacrolimus (Prograf) proved non-inferior to intravenous cyclophosphamide for treating lupus nephritis, researchers said.
Dr. John Cush
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TLR7 signaling impt to SLE as it drives type I IFN & activation of autoreactive B cells. Nature reports missense TLR7 (Y264H) variant from severe lupus induces guanosine & cGMP & causes murine lupus when introduced into mice. https://t.co/mzAWd3Pke8 https://t.co/knwa7fBLxk
Dr. John Cush
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Pregnancy outcomes in systemic sclerosis (SSc) studied in 154 pregnancies from SSc, SLE, APS, & controls (2008 to 2019). Adverse Preg Outcomes APO significantly higher in SSc vs HC (61% vs 10%) w/ more miscarriages, preeclampsia, SGA & preterm births https://t.co/P3uksmJy6V https://t.co/nTtgwjdGgL
Dr. John Cush
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SLE (n=2428) pts followed for 224,295 Pt-months- Osteonecrosis seen in 122 pts (6.5/1,000 PtYrs). Higher ON risk - African Americans (2x), Male (1.8x), smokers (1.5x). Higher Rates w/ high dose prednisone (not pulse or IM TCA) https://t.co/omU9Z1Z3kU https://t.co/wceGoCcUBV
Dr. John Cush
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COVID-19 Vaccination Uptake and Perceptions in Rheumatic Patients
Putman et al has reported vaccine survey results from the C19-GRA in Lancet Rheumatology showing the uptake and vaccine hesitancy among people with rheumatic diseases (RMD).
https://t.co/sqsOHGThzV https://t.co/zeZrlDeQ9Z
Dr. John Cush
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Taiwan claims data shows among 2050 new SLE, 783 on HCQ. HCQ had no effect on future development of CKD over 14 yrs. Yet some rec HCQ in all lupus nephritis to reduce kidney flares, ESKD and death. https://t.co/JS0ST1W0LW https://t.co/ihQp3d5rcy
Dr. John Cush
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ICYMI: SLE study from BC, Canada shows that among 3062 incident #SLE patients 96% received antimalarial (AM) Rx with only 40% adherent. Over a 6.4 yr F/U, 242 (8%) died. AM adherence was assoc w/ a 71% and 83% lower risk of death https://t.co/0uKAKJVxri https://t.co/KuvEA2pzrg
Dr. John Cush
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SLE study from BC, Canada shows that among 3062 incident #SLE patients 96% received antimalarial (AM) Rx with only 40% adherent. Over a 6.4 yr F/U, 242 (8%) died. AM adherence was assoc w/ a 71% and 83% lower risk of death https://t.co/S9LsDaSZNx https://t.co/lFWZJTh367
Dr. John Cush
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Increased Cancer Risk with Autoimmune Disorders (AID)
The incidence and mortality of cancer among AID was studied in a large Chinese cohort, demonstrating that while onset time and risks vary, there is an increased risk of malignancy in AID.
https://t.co/T2WkOWp0cA https://t.co/iNJioAvrIe
Dr. John Cush
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Systematic lit review of 5694 CTD pts (SLE, RA, IIM, SSc) admitted to the ICU shows overall risk of mortality was 33%. ICU admits mainly for sepsis (43%), flares(40%). Mortality risk was 70% in IIM, 40% SSc, 35% SLE subgroup, 20% RA. https://t.co/ubVujkLCNy https://t.co/nnJdO36imK
Dr. John Cush
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The Effect of Socioeconomic Status on Lupus Outcomes
Socioeconomic status (SES) often associates with poorer outcomes in systemic lupus erythematosus (SLE) patients; and a current study suggests this is unrelated to healthcare access issues.
https://t.co/J1BMlsakGN https://t.co/BNhCN89Pqv
Dr. John Cush
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Your Lupus Questions from RNL 2022
Rheumatologists questions for Dr. Jack Cush
QD Clinic is sponsored by RheumNow's PsA All the Way Campaign in April 2022
https://t.co/845D5KfUzY https://t.co/RtKopcTfiY
Dr. John Cush
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Study of 119 SLE pts (30 w CKD) shows urinary galectin-3 binding protein as a biomarker, increased w/ active LN, significantly (p<0.001)correlating w/ SLEDAI, SLICC RAS, histologic activity; higher in proliferative vs membranous LN (p=0.04) https://t.co/s8mRnfxIj6 https://t.co/s1OoiRy6Xi
Dr. John Cush
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Infection in lupus is suggested by very high CRP, PMN-lymph ratio (NLR) Plt-lymph ratio(PLR). Study of 104 hospitalized SLE found all very high w/ infx & Combined cutoffs of CRP >20 mg/L, NLR >3.5, PLR >151 had 87 sensitivity & 81% specificity for infx https://t.co/5SjFsrBiZp https://t.co/0Ipussd9fF
