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How Should Patients With Autoimmune Diseases Approach COVID Vaccination?

MedPage Today

Healthcare is a personal and individualized relationship between a provider and patient. Each patient is treated according to their particular symptoms and personal health characteristics.

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RheumNow Podcast – Rheumatologist Smoke-Enders (10.22.2021)

Jack Cush, MD

Today I have a few questions: Is tramadol really a weak narcotic? Should we really still be doing placebo-controlled trials? What are we going to do about our patients who are smokers? This and more, in this week's review of the news and journal articles.

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COVID Test Antibody

Is It OK to Continue TNF Inhibitors with COVID-19 Infection?

Jack Cush, MD

Registry level data of patients with immune-mediated inflammatory diseases (IMIDs) diagnosed with COVID-19 should continue their TNF inhibitor (TNFi) therapy as such patients were less likely to experience adverse COVID-19 outcomes (compared to other immunomodulatory treatments).

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RheumNow Podcast – Quackademia (10.15.2021)

Jack Cush, MD

Dr. Jack Cush reviews the FDA approvals, news and the latest journal articles from the past week on RheumNow.com.

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morbidity,covid,heart,lung,brain

2021 Update to EULAR Points on Immunomodulatory Use in COVID-19

Jack Cush, MD

EULAR has updated its recommendations (points to consider - PtC) for rheumatologists managing patients during COVID-19; now with 2 overarching principles and 12 PtC.

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aosd.CXR_.jpg (keep)

Still’s Disease Following COVID-19 Vaccination

Jack Cush, MD

Both systemic onset juvenile idiopathic arthritis (sJIA) and adult-onset Still’s disease are acquired autoinflammatory disorders of uncertain etiology. Yet recent reports of AOSD onset and flare following COVID-19 vaccinations may have important mechanistic implications.

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RheumNow Podcast – #ACA: Ask Cush Anything (10.8.2021)

Jack Cush, MD

Arthritis numbers are rising, and people are finally talking about osteoarthritis. Also, ACR 2021 is just a few weeks away - are you ready? Finally, I'll review cases and questions submitted by viewers in Ask Cush Anything (#ACA). This, and nearly a dozen news items and reports, are discussed in this week's podcast. Let's begin.

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MMWR reports those who have recv COVID-19 vaccine have lower risk non–COVID-19 mortality (vs unvaccinated). Adjusted rel risk of non–COVID-19 death for Pfizer-vaccine (2 doses RR 0.34), Moderna (0.31), Janssen (0.54). NO INCR MORTAL RISK IN VACCINATED https://t.co/X6X1w1aYoU

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New Download Available! FDA EUA for Baricitinib in COVID https://t.co/yTQLb7DDvR https://t.co/n9Npg0Pq5q

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From March to Dec 2020, study of 116K COVID pts saw monthly rates of hospitalization (105/100K), ICU admits (20/100K), & death (12/100K) -peaked 12/20. Highest w/ age >65yrs, hispanics, blacks. Remdesivir incr 1.7% to 54%; Steroids 19% to 74.2% https://t.co/5pzu74YIz6

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Israeli study of 1497 fully vaccinated health care workers finds 39 (2.4% Breakthrough COVID infections (Jan-May 2021), most cases were mild or asymptomatic, 19% w/ persistent Sxs (>6 ws); infected had lower neutralizing Abs. https://t.co/deYTVLRQCU

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RECOVERY study of hospitalized COVID-19 pts compared colchicine to PBO (+usual care). Colchicine had no effect on 28d mortality (21% vs 21%), time to D/C(10 d vs 10d), LIve D/C (70 vs 70%), mechanical vent or death (25 vs 25%) https://t.co/dYZglKzwxC

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JAMA reports the COVID-19 combined infection- and vaccination-induced seroprevalence estimate in May 2021 was 83.3% By May 2021, there were 2.1 SARS-CoV-2 infections per reported COVID-19 case. https://t.co/bUZ5AqYnxM

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EULAR has updated its recommendations (points to consider - PtC) for rheumatologists managing patients during COVID-19; now with 2 overarching principles and 12 PtC. Read more on #RheumNow https://t.co/Q422Sl5Csj

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In case you missed it… Still’s Disease Following COVID-19 Vaccination Read more on #RheumNow https://t.co/23R41Pydve https://t.co/a44cYIkc98

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For best practices in managing the Delta wave, the US would have done well to consult Puerto Rico US 26 cases/100,000 people, 19/100K hospitalized 57% vaccinated PR 3 cases/100,000 people, 3/100K hospitalized, 68% vaccinated https://t.co/kqlXBlmYpu
Eric Topol EricTopol ( View Tweet)
A case of reactive arthritis following COVID-19 infection; manifest as dactylitis, psoriatic skin/nail lesions, painful oral & vaginal ulcers, subungual hyperkeratosis, but no oligoarthritis, or lumbar pain. https://t.co/nobMHGgKfZ

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Could Auranofin work in COVID-19 infection? it may do so by inhibiting IL-6 production, as auranofin inhibits TLR3/TLR4, STAT3/JAK1 and thioredoxin reductase that regulates NF-kB (later IL-6); and may inhibit viral replication too. https://t.co/efLG4tzpTZ

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Anakinra appears to lower mortality risk (OR 0·32 vs historic controls) in hospitalized severe COVID-19 pneumonia (esp w/ hyperinflammation, CRP >100 mg/L). Metanalysis of nearly 2000 pts; better resp if given w/ dexamethasone (OR 0·23) https://t.co/7nFAkLgpGK

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WHO's Strategic Advisory Group on immunisation has advised an addition COVID vaccination in those >60 years and the immunosuppressed (due to a higher risk of breakthrough infections) https://t.co/NcGr8EMDaO

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