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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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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
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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
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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)
#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
Links:
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
Links:
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
Links:
Eric Dein ericdeinmd ( View Tweet)
