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Outcomes of COVID-19 in Patients with Rheumatoid Arthritis

Akhil Sood, MD

Patients with rheumatic diseases – requiring lifelong immunosuppressants— are at high risk for respiratory and viral infections. Over the past decade, an armamentarium of biologic and targeted therapies has led to better control of disease activity in patients with rheumatoid arthritis. Whether these patients, especially those receiving newer biological and targeted therapies such as JAK inhibitors, are at an increased risk of severe COVID-19 outcomes remains uncertain. 

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ACR21 Previews from Creaky Joints

Jack Cush, MD

CreakyJoints will present 11 posters and two oral presentations at ACR 2021. COVID-19 research revealed significantly high levels of anxiety, anger, depression, and social isolation, which were linked to medication interruptions and associated flares suggesting during the pandemic, patients often felt unsupported by all levels of the healthcare system. 

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Negative Concerns of Telemedicine in Rheumatology

Jack Cush, MD

Post-pandemic structured surveys and interviews with rheumatology patients suggests they may prefer for face-to-face consultations, as telehealth visits run the risk of diagnostic inaccuracies and safety concerns.

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Rituximab Patients May Benefit from Third COVID-19 Vaccine Dose

ACR

New research presented this week at ACR Convergence, the American College of Rheumatology’s annual meeting, shows immunocompromised patients using rituximab (a drug used to treat diseases like rheumatoid arthritis) were able to produce antibodies against COVID-19 (seroconvert) after receiving a t

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RheumNow Podcast – Like Father, Like Daughter (10.29.2021)

Jack Cush, MD

Bad things happen when our patients go into the ICU and it's not always due to the disease. Good things happen when we rise from sitting. And guess what? Rheumatologists are setting cardiology straight about hydroxychloroquine and chloroquine. This, and a special recognition of parent-child rheumatologists, along with the news and articles from this week on RheumNow.

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COVID-19 mRNA vaccination immunogenicity (vs immunocompetent): TNFi: 2.3x reduction JAKi: 2.6x AZA: 3.5x MTX: 4.4x steroids: 9x (but confounded by other meds) MMF/MPA: 21x B cell depleting: 57.7x (but 6m gap probably helps) amazing work led by @alhkim #ACR21 ABST0457 @RheumNow https://t.co/cl5vBpNzvQ
David Liew drdavidliew ( View Tweet)
Dr. @AlHKim on COVaRiPAD data: 274 pts chronic inflam dz (RA/SLE/IBD/SpA/MS/SS,/Vasculitis) vs 53 control 👉90% Ab+ response (⬇️3.4X titer) 👉MMF⬇️21X 👉MTX⬇️4.4X 👉AZA ⬇️3.5X 👉BCDT⬇️ 57.7X 👉JAKi ⬇️2.6 X 👉GCs⬇️9X 👉TNFi impaired neutralization delta #ACR21 #plenary @rheumnow https://t.co/b0DgLjDi6E
TheDaoIndex KDAO2011 ( View Tweet)
COVaRiPad study - Immunosuppression affects COVID-19 vax Ab levels. 247 pts, 90% seroconverted but @ reduced (3.4 fold) titers. Lowest w/ MMF (21x) and B cell Rx vs MTX/AZA (3-4x). Pts on B cell therapy should wait 6 mos to recv vax #ACR21 Abstr# 0457 https://t.co/1gkCsJSDBk
Dr. John Cush RheumNow ( View Tweet)
Our latest article on outcomes of patients with vasculitis and PMR and COVID-19 published in @TheLancetRheum . @rheum_covid project with co-leads @SattuiSEMD and @EBRheum . https://t.co/8NTAafdYRA

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Richard Conway RichardPAConway ( View Tweet)

#ACR2021 Remember, one reason belimumab is so safe is that it does not completely deplete B cells. Particularly important in times of COVID19. Dr. Petri #GreatDebate @RheumNow

Pedro Castillo _Castillo_Pedro ( View Tweet)

Dr Patel @jeffsparks @zach_wallace_md comparative cohort study on CD-20 inhibitors and COVID. ⬆️ mortality, aHR 2.16 . Abstr#0085 #ACR21 @RheumNow https://t.co/wyfEBWurRi
Richard Conway RichardPAConway ( View Tweet)
How can we tell whether a patient already on rituximab will have an immunogenic response to Pfizer COVID-19 vaccination? Better chance of response if: - RA or SLE, not AAV or IIM - high serum IgG pre-last RTX - longer time since last RTX Israeli data #ACR21 ABST0437 @RheumNow https://t.co/yyuFd0eDH6
David Liew drdavidliew ( View Tweet)
Excited for the first full day of #ACR21, reporting for @RheumNow! Esp looking forward to: ⭐Posters: #Epidemiology, #PublicHealth, #COVID19, #SpA, #RheumatoidArthritis, #PatientOutcomes ⭐Plenary session ⭐Scientific sessions covering #axSpA, #PsA and more

Mrinalini Dey DrMiniDey ( View Tweet)

Meta-analysis from @rheum_covid with @HsiehEvelyn shows that people with rheumatic disease are at⬆️risk of SARS-CoV-2 infection and⬆️mortality from COVID-19. Abstr#0086 #ACR21 @RheumNow #ACRBest https://t.co/B7tWs02gfc
Richard Conway RichardPAConway ( View Tweet)
COVID-19 has been tough on everyone, but especially tough on our patients in rheumatology. We need to think about the long-term impacts, but also about how we can do it better next time. @HSpecialSurgery #ACR21 ABST0266 @RheumNow https://t.co/JdOqZ8Svin https://t.co/c0rlY9PfDv

Links:

David Liew drdavidliew ( View Tweet)
“It all begins with empathy!” Dr. Karp regarding difficult unknown/long haul COVID19 symptoms in our patients. #ACR21 @RheumNow

Dr. Rachel Tate uptoTate ( View Tweet)

Michael Brenner, Basic Science Year in review: Auto-antibodies against interferon, present prior to COVID-19, mostly in men and increases with age: increases risk to #COVID19 mortality #ACR21 @RheumNow https://t.co/5sFqcBtStD
Eric Dein ericdeinmd ( View Tweet)
OK this one is cool. RNA technology used as pro inflammatory in #COVID #vaccinations but paper of RNA vector giving immunetolerance in mouse model of encephalitis. #ACRBest Yr in Review by M Brenner discussion of paper. Double edged sword ⚔️ @RheumNow #ACR21 https://t.co/8sRl351D27
Janet Pope Janetbirdope ( View Tweet)
Join us tomorrow at #ACR21 in the #COVID19 hub at 12p EST where I’ll be discussing outpatient management of high risk covid patients with @LCalabreseDO #mAbs @philipcrobinson @ACRheum https://t.co/LkSw48cnWw
Cassandra Calabrese CCalabreseDO ( View Tweet)
#ACR21 Anti-IFN autoantibodies predisposing patients to severe COVID ...🤔 And can be done with quantiferon test! https://t.co/n3h4vpQGdR
LiSa ◡̈︎ rheumarhyme ( View Tweet)
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