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Late breaking, but just in time! mRNA COVID-19 3rd dose in RTX pts, w/o Ab response post initial series. After 3rd dose many had ab response or T cell response.
Extra vaccine full doses can protect RTX pts from COVID! AbsL17 #ACRbest #ACR21 @RheumNow https://t.co/lIDPzybmT7 https://t.co/jEJ3N6cdjK
Dr. Rachel Tate uptoTate ( View Tweet)
Complications of Covid19 in Lupus: Dr. Kathryn Dao ( @KDAO2011) discusses abstract #1933 presented at the #ACR21 annual meeting.
https://t.co/jKFJwCBeCo https://t.co/ncleyYZWLn
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Dr. John Cush RheumNow ( View Tweet)
#ACR21 L17: Heterologous vs Homologous Booster vax
▶️RTX non-responders to mRNA: Randomized to mRNA 3rd dose vs AZ vax
⭐️Majority of pts develop immune response (humoral and/or cellular) after 3rd dose, no statistical diff b/w groups
@Rheumnow https://t.co/cuM9LcEr4u https://t.co/cmNBNSIoOl
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Eric Dein ericdeinmd ( View Tweet)
What to do w Rituximab users and #COVID19 vaccine? #Rituximab no seroconversion 30% with 2 #COVIDVaccination. With 3rd vaccine dose up to 94% can have immune response! Pts need their 3rd vaccination @RheumNow #ACR21 #ACRBest abstL17 https://t.co/0GHOuoqPKQ
Janet Pope Janetbirdope ( View Tweet)
👉29% of pts on RTX fail to mount a humoral OR cellular response to #COVIDvaccine & have⬆️hosp,⬆️hosp stay,⬆️severity, persistent viremia,⬆️deaths)
👉study adding booster (AZ or mRNA) overcomes this, enhancing humoral and cellular response
#ACR21 @rheumnow Abst#L17 https://t.co/yuX1TT6ZBF
TheDaoIndex KDAO2011 ( View Tweet)
Very interesting talk Abst L16
Singh & colleagues found that patients with rheumatic diseases are at increased risk for breakthrough infxn
- Recent drug exposure and certain medication type can influence outcomes
- Findings support need for 3rd dose in RD pts
#ACR21 @RheumNow https://t.co/vU6ZNIEWbc
Akhil Sood MD AkhilSoodMD ( View Tweet)
USA EMR (N3C) Data on 577,335 Rheum Pts w/18,164 #COVID19 breakthrough infx (BTI)
👉91% vax'd
👉3.1% w/BTI
👉86% were vax'd May 2021 or earlier
👉More BTI w/Pfizer
👉BTI higher in inflamm myositis, RA
👉Drugs assc w/BTI: biologics, mult DMARDs
#ACR21 @rheumnow Abst#L16 #ACRbest https://t.co/Eu77vAAk3N
TheDaoIndex KDAO2011 ( View Tweet)
#ACR21 L16 - Breakthrough #COVID19 in rheum pts
⭐️Breakthrough ifn ~4%, compared to 3% wo rheum disease. Statistically signif ⬆️ risk in RA, gout, polymyositis, vasculitis, multiple rheum disease
⭐️bDMARD, multiple AIRD risks
@Rheumnow https://t.co/cuM9LcEr4u https://t.co/Los2n7BoIn
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Eric Dein ericdeinmd ( View Tweet)
Great case where the #COVIDvaccine was blamed, but he had a diet of doughnuts, steak&cheese sandwiches w/snack cakes, and popsicles. #ThievesMarket #ACR21 @rheumnow https://t.co/J78Nw5NhKs
TheDaoIndex KDAO2011 ( View Tweet)
Abst1625 #ACR21 @RheumNow study of kids w/covid induced MIS-C: 91% w/shock & GI ax, conjunctivitis & mucocutaneous involvement. ⬆️CRP,D-Dimer, Troponin, &BNP. On ECHO, 36% had myocardial dysfunction &27% coronary artery abnormalities. 64% required ICU admiss. Rx IVIG& steroids
Olga Petryna DrPetryna ( View Tweet)
#SARSCoV2 infections in vaccinated pts w/ #rheumaticdisease @rheum_covid @rheum_cat
👉🏼Most pts with breakthrough infections were on anti-metabolites or B-cell depleting therapies
👉🏼Encourage patients to get their #BoosterShot!
Abs#L04 #ACR21 @RheumNow
https://t.co/TAB4zrjPN1 https://t.co/z0gpsxN3xc
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR21 Ab#L02 - #COVID19 vax in rheumatic pts:
❌No ⬆️ in disease activity scores post-vaccination
❌No serious adverse event
▶️Vax response 88% in RA, 78% in SLE, 87% other rheum diseases after 2 shots vs 100% controls
⭐️RTX and MMF ⬇️ responses
@Rheumnow https://t.co/BChhmW0jpy https://t.co/2q8IKRoYqW
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Eric Dein ericdeinmd ( View Tweet)
#ACR21 Ab#L03: B cell depletors and #COVID19 vax:
⭐️B cell count <40 around vax had lower response to vax, than 40+ B-cell, independent of RTX or BEL
▶️ Timing of vax around B cell return can improve response
@Rheumnow https://t.co/1B7Bnb1QQu https://t.co/bKnfw6gD8O
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Eric Dein ericdeinmd ( View Tweet)
Breakthrough COVID-19 in rheum pts: great data @rheum_covid
B-cell depleting agents overrepresented, esp in hospitalization in fully vaccinated - but plenty of others
Booster (& booster booster) vaccine doses + other mitigation badly needed!
@rheum_cat #ACR21 ABSTL04 @RheumNow https://t.co/92Sn3mCwAi
David Liew drdavidliew ( View Tweet)
#ACR21 L04 @rheumcat on #COVID19 in vaxed pts
▶️87 pts in @rheum_covid w/ ifn s/p full vax. 110 partial vax pts
⭐️25% (22/87) full vax pts hospitalized. 45% on BCDT. 8/22 hospitalized had lung disease, 5 no other co-morbidities. 5 deaths (23%).
@RheumNow https://t.co/DB8C6jKvuU https://t.co/dxUwjTRxxb
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Eric Dein ericdeinmd ( View Tweet)
#ACR21 #Abstr1541 Any tools to help differentiate MAS vs #COVID inflammatory response? Preliminary criteria showed Sensitivity: 79.6%; Specificity: 81.3% within 6 days admission. No Triglyceride/Fibrinogen compared to 2016 ACR-EULAR & 2004 HLH @RheumNow https://t.co/c7pHaVCr5S https://t.co/6irF64qizI
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#ACR21 Abs#1536
#Vaccine uptake in people with #RheumaticDisease
👉🏼High uptake of vaccines in ~240 pts @BrighamWomens
👉🏼84% pts wanted the #COVID19 vaccine
👉🏼Physician recommendation was key determinant of uptake
@RheumNow
https://t.co/us0i5CW5Mi https://t.co/aLZmOPWFR3
Mrinalini Dey DrMiniDey ( View Tweet)
ACR21 Best Abstracts We Saw - Day 3 (Monday)
The third day of ACR 2021 took a big leap in online content. Here is a compilation (with links) of presentations were the “ACRBest” as seen by our RheumNow faculty.
Read Article
🆕 Updated 2021 ACR Guidance for Adjusting Immunomodulatory Therapy with the COVID-19 Vaccine in Patients with Rheumatic & MSK Diseases
Discussed at #ACR21 COVID-19 Hub!
V4 Link: https://t.co/1SOR9yTQyF https://t.co/PKFKXpLofN
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Mithu Maheswaranathan, MD MithuRheum ( View Tweet)
#ACR21 Year In Review: Factors associated with #COVID deaths in pts with #RMD:
⛔️age, male, HTN/CVD, lung disease, steroid>10mg/d, ⬆️disease activity
⛔️RTX (OR: 4), SFZ (3.6), other IS (2.2), No DMARDs (2.1) vs MTX monotherapy as reference @RheumNow https://t.co/Zd6qXCtGLk https://t.co/YHBEelLqKB
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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)