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Among patients with rheumatic diseases, age and female sex were important factors associated with the development of a first adverse event after initiating biologic treatment, Spanish researchers reported.
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Add this to the list of hydroxychloroquine (HCQ) letdowns in managing COVID-19 treatment or risk - prophylaxis with HCQ fails to prevent COVID-19 infection in those exposed to the SARS-CoV-2 virus.
NEJM has reported a prospective, randomized, double-blind, placebo-controlled trial from the US and Canada wherein adults with household or occupational exposure to someone with confirmed Covid-19 were treated with either placebo or HCQ within 4 days of exposure.
Article
Several recent reports offer conflicting views on the potential benefits and adverse outcomes of IL-6 inhibition with tocilizumab (TCZ) therapy in patients with severe COVID-19 infection.
An Italian study grabbed the headlines yesterday with a press release stating TCZ did not improve respiratory symptoms, ICU admissions or mortality rates when given to 126 COVID patients with early disease. The study, supported by the Italian Medicines Agency (Aifa), stopped enrollment (about 1/3 of projections) after an interim analysis found insufficient evidence that TCZ would be effective. This report has not been published or undergone critical review.
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Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.
Dr. John Cush
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TNFi, ABA, TCZ Retention rates looked at in 1362 RA according to age. For < 65 years, 3-year retention was best for TCZ 69%. For pts 65–74 years, retention rates highest for TCZ . For ≥ 75 years, 3-year retention rates best for ABA & TCZ (63% & 58%). https://t.co/7RRO9M4Wf0
Dr. John Cush
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Comparison of elderly-onset (>60yrs) #RA (EORA) to younger-onset (YORA) finds significantly more treatment resistant synovitis and Xray progression in EORA pts with worse overall prognosis compared to YORA (clinical, UA, and pathology). https://t.co/17XSz3Ilap
Dr. John Cush
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Metanalysis of 8 studies and >130,000 patients shows that IBD (Crohns & UC) have a significantly higher risk of developing #RA (RR = 2.59; 95% CI: 1.93–3.48). https://t.co/ipYRZ6DQPQ
Dr. John Cush
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Pt w/ severe systemic JIA & recurrent macrophage activation syndr underwent whole exome sequencing & found to have gain in function CASP1 variant leading to inflammasome & NF-κB hyperactivation (hi IL-6, IL-1β IL-18, IFNγ) Rx w/ IL-1 & IL-6 inhib https://t.co/SE3p5CTEak
Dr. John Cush
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23 yoF with 1 mos digital ulcers, hair loss, sicca Sxs, dysphagia; No sclerodactyly but finger tips cyanotic w/ distal pitting scars, ischemic ulcers, periungual erythema & dilated nailfold capillaries (no hemorrhages). +tests for ANA, Ro52, Ro60 and Scl-70 Abs. How to treat?
Dr. John Cush
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A negative RCT shows yearly treatment with Zolendronic acid fails to change tibiofemoral cartilage volume (by MRI) in Knee Osteoarthritis patients with bone marrow lesions. 223 knee OA pts recv ZOL vs PBO x24 mos , w/ no change inVAS pain (-11.5 vs -16.8) https://t.co/N7N0rL8iCX
Dr. John Cush
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35 pregnant women w/ baseline & postpartum MRI-SIJ. 27/35 (77%) had SI bone marrow edema postpartum, 60% met ASAS definition of +MRI. 6 and 12 mos after, 46% and 12% still showed BM edema. Findings assoc w/ short labor & no epidural https://t.co/mhX3W96zR3
Dr. John Cush
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NEJM case report of PD-1 inhibitor induced immune related colitis successfully treated with tofacitinib 10 mg bid for 30 days - patient improved after 5 days of TOFA. https://t.co/skfU6TKnlK
Dr. John Cush
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WHO global safety database shows increased risk of DVT & PE with tofacitinib & baricitinib, who were likely to be older with preexisting VTE risk. In EU, TOFA risk for DVT/PE was OR 2.3; BARI risk was OR 3.4. No VTE risk for BARI in US, TOFA 2.0 VTE risk https://t.co/PUBUzfrydn
Dr. John Cush
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Early COVID 1255 patients In Wuhan, China - median age 64 yrs; 53 male: 63% w/ chronic comorbidities. There were 17 autoimmune pts w/ COVID () - median age 64; 83% female; only 1 admitted to ICU and one died. 10 stopped DMARDS & 5 their Dz worsened https://t.co/1KgU9tYUqV
Dr. John Cush
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NGF inhibitor Tanuzemab (TNZ) phase III study in patients with low back pain - H2H against placebo and tramadol. At 16 wks, ≥50% improvement in LBPI was 37%, 43% TNZ 5mg and 46% TNZ 10mg (Odds ratio [95% CI] vs placebo = 1.45 [1.09, 1.91; P=0.0101]). https://t.co/3DvUHtxcqk
Eric Topol
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The 5 states with the highest slope of case increasing, per million population, June 20th
1. Arizona (way out in front)
2. South Carolina
3. Florida
4. Texas
5. Oklahoma (pre-rally) https://t.co/M1PsBgmhJb
Dr. John Cush
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#EULAR2020 Round-Up w/ Drs. Kavanaugh & Cush. Watch it on RheumNow https://t.co/5v9BTuLrPX or listen to the podcast on iTunes https://t.co/FHJv01AAbC or on Android Sound Cloud https://t.co/nb7iXdRMMb
Dr. John Cush
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RheumNow Podcast is Up! New FDA approvals for secuminumab, canakinumab, risk of GI perforations, tocilizumab in COVID, Weaning DMARDs/Biologics and Blacks with AS. Watch here>> https://t.co/2fTQPJ5iSr Listen to the podcast on Soundcloud>> https://t.co/uPklKQEauE
Dr. John Cush
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Study of 260 pts with cutaneous lupus shows higher CLASI (skin activity) scores were associated with smoker, higher CRP, and chronic CLE disease https://t.co/X1eJel9CLP
Dr. John Cush
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Congratulations to Christopher Buckley, Kennedy Professor of Translational Rheumatology at the University of Birmingham and Oxford, for being awarded the 2020 Carol Nachman prize for Rheumatology https://t.co/xis9RmsoCf
