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RheumNow Podcast – COVID-19 Responds to Steroids (7.24.20)

Jack Cush, MD

Dr. Jack Cush reviews the News and Journal Reports from the past week on RheumNow.com.

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Low Risk of COVID in Biologic Treated Rheum Patients

Jack Cush, MD

In an Annals of Rheumatic Disease report, Italian investigators performed consecutive testing for SARS-CoV-2 (IgM and IgG) between 25 March to 25 May 2020 and compared test results between rheumatic disease (RMD) patients and the general population. 

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RheumNow Podcast – LTF – Listen to Fauci (7.17.20)

Jack Cush, MD

Dr. Jack Cush reviews the news, tweets and journal articles from the past week on RheumNow. Let's dig into this week's 14 highlights.

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HCQ May Help Prevent Fetal Heart Block

RheumNow

Hydroxychloroquine (HCQ) helped reduce recurrent maternal autoantibody-mediated congenital heart block (CHB) in fetuses, an open-label study suggested.

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Extrapulmonary Manifestations of COVID-19

Jack Cush, MD

A new article in Nature Medicine delineates how our understanding of COVID-19 infection has evolved over time, such that the infection outomes may be worsened by extrapulmonary manifestations; notably thrombotic, cardiac, renal, gastrointestinal hepatic, neurologic, and other complications.

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ICYMI: COVID-19 and Thrombotic Complications

Jack Cush, MD

Severe and fatal outcomes with coronavirus infection are often the result of the downstream damage that follows the viral infection. Rising high on the list of complications are the hematologic and vascular complications seen in severely affected patients, so much so that many centers are routinely anticoagulating hospitalized (but not ambulatory) COVID patients.

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FDA recommends health care professionals discuss naloxone with all patients when prescribing opioid pain relievers or medicines to treat opioid use disorder. Naloxone can be administered(+/- medical training) to help reduce opioid overdose deaths https://t.co/9B0hPhOm57

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Dr. John Cush RheumNow ( View Tweet)

Belimumab FDA approved in kids (same dose 10mg/kg/IV) based on PLUTO trial - 93 SLE pts Rx w/ BEL or PBO. By wk 52, BEL had more SRI4 responders (52.8% vs 43.6%; OR 1.49;95% CI 0.64 to 3.46), more PRINTO/ACR 30 or 50 w/ stable PK. https://t.co/1xX0VLgl4q

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Dr. John Cush RheumNow ( View Tweet)

FDA has issued draft guidance on Cannibis research: “Cannabis & Cannabis-Derived Compounds: Quality Considerations for Clinical Research, Draft Guidance for Industry,” outlines FDA’s current thinking on clinical research related cannabis-derived compounds https://t.co/ppvisN1oxU

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Dr. John Cush RheumNow ( View Tweet)

Aurinia Announces U.S. Food and Drug Administration Acceptance of the Filing of New Drug Application and Priority Review for Voclosporin for the Treatment of Lupus Nephritis https://t.co/BMgqvuAUP5

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Dr. John Cush RheumNow ( View Tweet)

RheumNow Podcast is Up! Listen to Fauci! Watch it here>> https://t.co/dHq3fP85Ip or Listen to the Podcast>> https://t.co/LdHO7fKUCp

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Dr. John Cush RheumNow ( View Tweet)

Retrospective study of 603 myositis (IIM), 4047 RA and 4061 controls shows IIM has higher risk of CV events (HR 1.38) and MI [HR 1.61] but not CVA [HR 0.92]. The CV risk in IIM was equal to that in RA [HR 1.01]. IIM CV risk only present 1st 5 years https://t.co/EyD3GHv2YY

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Dr. John Cush RheumNow ( View Tweet)

The preliminary #ACR20 schedule is here! Along with all your favorite plenary and networking sessions, the program will feature #Rheumatologist Dr. Anthony Fauci giving us a live update on #COVID19. @ACRheum #ACRConvergence - Where Rheumatology Meets https://t.co/IWbiVw9PSP

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Victoria Shanmugam VickiShanmugam ( View Tweet)

Ghent Univ experience and literature review shows that diffuse and localized scleroderma occurs in 2.4 to 7.4% often with Raynauds (6/8), scleroderma pattern on nailfold videocapillaroscopy and SSc-specific autoantibodies https://t.co/zDgXsuKD3p

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Dr. John Cush RheumNow ( View Tweet)

JAMA Internal Medicine reports that the number of hydroxychloroquine prescriptions increased from 367,346 to 683,999 (86.2%) from February to March 2020, and chloroquine prescriptions increased 158.6%, rising from 2,346 to 6,066 prescriptions. https://t.co/3MKsu5mOpx

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Dr. John Cush RheumNow ( View Tweet)

Nice overview of Lupus Nephritis (III, IV, V) and biopsy results from the Renal Fellow Network https://t.co/tw1d5ldM04

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Dr. John Cush RheumNow ( View Tweet)

SLE study from UK Clinical Practice registry matched 4343 SLE pts 1:6 controls; found lupus had 80% increased mortality risk (HR 1.8; CV, infx, Resp, accident/suicide). Higher risk w. younger onset & steroid. HCQ significantly lowered mortality risk (45%) https://t.co/c3IfiSydRr

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Dr. John Cush RheumNow ( View Tweet)

Skin is often involved w/ ANCA+ vasculitis - 1184 AAV pt study shows skin involvement in 34% GPA; 28% MPA & 47% EGPA. Common are petechiae/purpura pruritus, urticaria, and maculopapular rash. AAV w/ skin Sxs have more systemic dz (GN, alveolar hemorrhage) https://t.co/egPdW2IEnu

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Dr. John Cush RheumNow ( View Tweet)

#EULAR2020 #op0201 nationwide cohort study: higher incidence of dementia in SLE (3.9/1000pys) vs non-SLE ( 2.73/1000pys). HR 1.43. SLE risk of Alzheimer’s 1.4x &risk of vascular dementia 1.6x Higher than non-SLE cohort. Further studies to identify mechanism needed @RheumNow https://t.co/IL6KPvP320

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Dr. John Cush RheumNow ( View Tweet)

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 RheumNow ( View Tweet)

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