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Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.
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In difficult times, it's reassuring to reflect on the similarities that bring us together. In the case of the EULAR and ACR COVID19 guidelines as discussed at #EULAR2020 by Drs.
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NEJM has reported that the use of hydroxychloroquine did not prevent symptomatic COVID-19 infection when used within 4 days after SARS-CoV-2 exposure.
Currently for persons who are COVID exposed, the standard of care is quarantine and there is no known preventative therapy.
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Gianfresco et al have published the first peer-reviewed analysis of COVID-19 infected, rheumatic disease patients entered into the Rheumatology Global Alliance registry; showing that a) rheumatic disease patient can be infected with COVID-19, b) that DMARD and biologic use has no apparent effect on outcomes and c) steroid increase and TNF inhibitor decrease the odds of hospitalization.
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Two current reports from Boston and Wuhan describe cohorts of COVID-19 (+) rheumatic disease patients who generally do well but appear to have a higher risk of pulmonary involvement.
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Hydroxychloroquine (HCQ) has dominated the news in recent weeks, because of poor outcomes reported when used in COVID patients. Yet, a recent report reaffirms what rheumatologists have known for years - that HCQ use is associated with better outcomes in systemic lupus erythematosus, including survival.
David Liew
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Is there subclinical GCA in PMR pts?
50 consecutive PMR pts had vascular USS. 27/50 had GCA vascular uptake, of which 10 had no GCA symptoms at all.
Is PMR sometimes just the tip of the GCA iceberg? Do the aSx USS+ pts get GCA Sx eventually?
Bonn SAT0254 #EULAR2020 @RheumNow https://t.co/UmsixY29Qh
David Liew
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GCA and cancer: it's been hard to tease apart, lots of cofounders. We've needed large cohorts with comparators & detail.
Large Israeli database says there are links
(EMR/claims/prescribing combined, n = 4.4m w validated incident GCA set). If so, why?
OP0143 #EULAR2020 @RheumNow https://t.co/kSPGnxNjah
k dao
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#EULAR2020 Prof. T Domer: baricitinib show promise in phase II trial for SLE: Microarray analysis noted reduction in IFN signature; however, the reduction did not correlate w/SLEDAI-2K or SRI4 clinical response @RheumNow https://t.co/cW4egzSnAs
k dao
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#EULAR2020 Most innovative! Vaccination with IFNa-kinoid to induce anti-IFNa antibodies to treat SLE (results of phase IIb trial). https://t.co/rM0z23ieQW @RheumNow https://t.co/OYMdDZl6sb
k dao
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#EULAR2020 OP0160 Prospective study of Hopkins Lupus Cohort: HCQ blood levels can predict risk for thrombotic events in SLE. Dr. M Petri advocates this is another reason for monitoring HCQ whole blood levels. Goal HCQ whole blood level should be 1000-1500 ng/mL @rheumnow https://t.co/mM6jsJ2Qmf
k dao
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#EULAR2020 OP0163 Updated Lupus Nephritis EULAR/ERA-EDTA Recc:
1. T2T:⬇️proteinuria 50%@6 mo,UPCR<700 mg/g@12mo
2. Class III/IV:MMF, Euro-CYP; MMF+CNI
3. goal pred < 7.5 mg/day@6 mo
4.Class IV: MMF, CNI, CTX
5. Maintain w/MMF, AZP
6.🔃renal Bx w/refract. dz @RheumNow https://t.co/tGaSIDG1ji
k dao
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#EULAR2020 Dr. Kimme Hyrich reviews the EULAR #COVID19 Registry "Most individuals with rheumatic diseases receiving immunosuppressive therapies recover from COVID19" @rheumnow https://t.co/EdVLUMyHhF
k dao
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#EULAR2020 panel on #COVID19 spec. situatns:
1. German regtry: very few preg rheum pts w/CV19; cases mild.
2. No info how CV19 affects APS
3. Very few ped rheum cases of CV19- cases mild; outcomes sim to gen peds pop
4. Most rheum pts w/CV19 good prognosis @rheumnow https://t.co/LQVdzJKCgu
Olga Petryna
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#eular2020 #op0302 Ianalumab (VAY736) dual action BAFFreceptor inhibitor/B cell depletion meets primary end point in p2b for pSS: EESDAI⬇️1.92 pts over PBO at wk24. Dis not meet 2ry endpoint ESSPRI&FACIT-F. Good side effect profile w/mild inj site reactions mostly @RheumNow https://t.co/9qsfUNho9h
dr hanady manasfi
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New #therapeutic strategies in #SLE management
#EULAR2020 https://t.co/dhvTKd4EGB
Janet Pope
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Our study shows that HCQ retinopathy virtually never occurs in first 5 yrs, SLE has more risk than other diseases such as RA and chloroquine has a far higher risk of retinal toxicity OP0333 #EULAR2020 @RheumNow @CRASCRRheum @earlyarthritis https://t.co/ZzRy3po4yw
k dao
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#EULAR2020 OP0167 Results are finally in!!
MMF can be safely w/drawn in quiescent SLE: prospect RCT (nonblinded) 102 pts. MMF tapered over 12 weeks, f/u 60 weeks; no sig diff for flares in pts who stopped MMF vs. maintained; pts who cont MMF had ⬆️ minor infections. @rheumnow https://t.co/bOnuEBLis9
Dr. John Cush
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Review of Rheumatic Sxs with Immune checkpoint inhibitors - Common are inflammatory arthritis, PMR & myositis. Non-MSK Sxs include sicca, vasculitides and sarcoidosis. SLE and scleroderma are extremely rare. Majority can be Rx w/ steroids. https://t.co/hku5L7hypo
Dr. John Cush
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A patient service Video - How to Manage your Arthritis Medications (in the time of COVID) - View the video here: https://t.co/hWW0h8wCZn or listen to the podcast on iTunes or here>> https://t.co/8wV4V2pYY5 https://t.co/SldbyCBDeI
