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RheumNow Podcast - ACR 2021 Rehash (the good stuff..)
The ACR 2021 meeting has concluded. Dr. Jack Cush recounts a few more great abstracts from this past week’s virtual meeting.
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Can "Ultra-low" dose Rituximab work for RA?
The REDO trial presented data in abstract 1443 in an oral presentation challenging how low we can go with rituximab for rheumatoid arthritis. Their study randomized 118 patients with rheumatoid arthritis to 1000 mg, 500 mg, and "ultra-low" dose 200 mg.
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Day 4 Report from ACR21
My favorite three presentations from day 4 (Tuesday) at ACR 2021 included the following.
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ACR21 – Day 3 Report
Hitting the home stretch, day 3 presentations were big! Here are a few of my favorites: secukinumab efficacy in juvenile PsA; VEXAS - predicting poor outcomes; and the FDA Safety Update session.
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Love this COVID ARDS risk calculator put forth by @JYazdanyMD at #ACR21 for our patient's with Rheumatic Diseases. A wonderful resource in talking to our patients about vaccine necessity! @CleClinicMD https://t.co/EA5jVYweHm
Emily Littlejohn ELittlejohnDO ( View Tweet)
#ACR21 Late breaking
#ACRambassador
Breakthrough COVID-19 Infections Post-vaccination Among Immunocompromised Patients with Autoimmune or Inflammatory Rheumatic Diseases: A Retrospective Cohort Analysis from a U.S. Nationally-sampled EMR Data Repository https://t.co/oyovR27Upm
Marie Kuchynski MD Doctorkuch ( View Tweet)
Reasons for COVID-19 vaccine hesitancy in rheumatology pts in southeast US based on survey study:
🔰Vaccine being “rushed” or “experimental”
🔰Safety of vaccine in the patients’ rheumatologic diagnoses
🔰Side effects
🔰Concern for Allergic reaction
Abst#1589 #ACR21 @RheumNow https://t.co/xm15KxdA56
swethaann23 swethaann23 ( View Tweet)
Factors Associated with Poor Vaccine Response in Rituximab: Dr. Yuzaiful Yusof (@Yuz6Yusof) discusses abstract #0437 presented at the #ACR21 annual meeting.
https://t.co/T0PFiZlbTa https://t.co/idj5T7j7ke
Links:
Dr. John Cush RheumNow ( View Tweet)
Update on Safety, Effectiveness of SARS-CoV-2 vaccines in SLE from Dr. Yuz Yusof ( @Yuz6Yusof)
It's almost a year since the Pfizer-BioNTech SARS-CoV-2 vaccine has been made available by the FDA under EUA. But is the vaccine safe for people with lupus?
https://t.co/i3HeCvS6El https://t.co/Tn0nWKrK4T
Links:
Dr. John Cush RheumNow ( View Tweet)
GRA @rheum_covid data presented by @mugartegil. African-American and Hispanic individuals with SLE have MUCH worse COVID-19 outcomes. Likely related socioeconomic and health disparities. Abstr#1933 #ACR21 @RheumNow https://t.co/YUoOeIxN7O
Richard Conway RichardPAConway ( View Tweet)
🚫Infection risk after COVID vaccination: US database
536 954 Controls and 47 303 pts w/ RMDs
〽️BNT162b2 19 vs. 36/1000
〽️ mRNA-1273 16 vs. 33/1000 〽️Janssen 26 vs. 47/1000
Infections ⬆️ RA, SpA, SLE, SSc, Polymyositis
#ACR21 #AbstL16 @RheumNow
https://t.co/xzOaFIu06e
@RheumNow https://t.co/tmr4USETJ3
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
#ACR21 #AbstrL17 In pts treated with Rituximab, arrange a 3rd primary dose ASAP regardless mRNA or vector #COVID vaccine. An RCT of N=60 pts who did not seroconvert after primary dose, overall 94% either seroconverted/new T-cell response @RheumNow #ACRBest https://t.co/F15j93OFE4 https://t.co/tXoisoYthx
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
CH COVID 19 Poster Review
Abst 0196
Jackson & colleagues performed double blind RCT of anakinra in patients with features of COVID-19 cytokine storm
- Anakinra + GC did not significantly impact outcomes in patients with cytokine storm syndrome
#ACR21 @RheumNow https://t.co/hX7bBtrIzT
Akhil Sood MD AkhilSoodMD ( View Tweet)
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
Links:
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
Links:
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)
