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My exclusive interview w/the GRA Powerhouse!
What are they studying next?
👉impact of COVID policies on Rheum pts
👉pt's perception w/COVID vaccines
👉COVID risk calculator
👉long haulers w/ rheum dz
👉breakthrough infections
@rheumnow https://t.co/dVLayNchHT @rheum_covid https://t.co/B1KIjxYt15
TheDaoIndex KDAO2011 ( View Tweet)
Abs 457 #ACR21 @rheumnow
Exciting work by @alhkim and colleagues on SARS-CoV-2 Vaccination in CID patients
- Most (90%) developed Ab response but with reduced titers
- GC users including some low dose mounted low responses
- TNFi reduced in vitro neutralization of delta variant https://t.co/fJxnKmbccc
Akhil Sood MD AkhilSoodMD ( View Tweet)
Abs0266 #acr21 @RheumNow study of impact of pandemic on pts w/SLE (67%), RA (19%), & pSS (8%): 63%reported a flare since the pandemic & 16% had COVID-19. 19% reported no changes to their care.76% reported a change in their mood& emotional health. Was your pts experience similar?
Olga Petryna DrPetryna ( View Tweet)
#ClinicalPearl. During Q&A of abst#0457 Kim A, et al plenary at #ACR2021 #ACR21 Dr Kim said with 3rd #COVIDvaccination dose the pts who had little or no response to spike protein DID mount a response. 3rd dose in vulnerable pts works #ACRBest @RheumNow
Janet Pope Janetbirdope ( View Tweet)
The good news: Most (around 90%) of people with chronic #inflammatory disease produced antibodies after the #COVID19 vaccine, but it was reduced compared to that of generally healthy people.
#ACR21 #Plenary
@alhkim https://t.co/KdWtIuuOtA
CreakyJoints.org CreakyJoints ( View Tweet)
plenary I. #ACR21
Interesting data with the delta variant from @alhkim https://t.co/oUCOXSc9wA
Marie Kuchynski MD Doctorkuch ( View Tweet)
@alhkim presenting COVaRiPAD data on SARS-CoV-2 vaccination. Most mount immune response. Risk of poor response BCDT >> MMF >> GCC > MTX/AZA/JAKi/TNFi > immunocompetent. Abstr#0457 #ACR21 @RheumNow https://t.co/lf8cAEWGXf
Richard Conway RichardPAConway ( View Tweet)
Abst0437 #ACR21 @RheumNow factors assoctd w/poor response to mRNA Covid-19 vaccine in rheum pts Rx w/Rituxan: ⬆️ exposure to RTX over time, ⬇️ IgG levels prior to RTX, short interval btw RTX course & BNT162b2 vacc. RA highest&ANCA-vasculitis lowest probability for a + response. https://t.co/DsrJBlNvr7
Olga Petryna DrPetryna ( View Tweet)
#ACR21 Abst#0457: #COVID19 Vaccine Responses In Patients w Autoimmune Diseas
⭐️Prosp observ: pre-vax▶️5 mo.
⭐️ 90% +Ab responses, but ⬇️ titer
⭐️MMF 21x⬇️ titer, MTX 4.4x⬇️, AZA 3.5⬇️
⭐️BCDT: 58, JAK: 2.6, TNF 2.3
⭐️GC ⬇️ even on <5mg!
https://t.co/BGU4CP9M0s @Rheumnow #ACRbest https://t.co/7QhsTGTwnZ
Links:
Eric Dein ericdeinmd ( View Tweet)
#ACR21 Plenary Abs#0457 @alhkim #COVaRiPAD study:
👉Patients with inflammatory diseases on #immunosuppression have impaired #SARSCoV2 immunity post-vaccine
👉#Steroids, MMF & B cell depletion therapy more severely affect responses
👉https://t.co/7qTABcpm0h
@RheumNow #ACRBest https://t.co/EfuHjh3vw5
Mrinalini Dey DrMiniDey ( View Tweet)
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
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
David Liew drdavidliew ( View Tweet)
