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RheumNow Podcast – I Wanna New Drug.V2 (9.24.2021)

Jack Cush, MD

Almost three years ago to the day, I did a podcast entitled, "I wanna new drug." As I go over this week's podcast, I want to say it again. I want a new drug safe enough to use during pregnancy, for PMR, for GVHD, and more. I'm going to cover these, and other topics including lupus, COVID breakthrough infections, and statin use and the risk of RA, as I review the news and journal articles from the past week on RheumNow.

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Worrisome Maternal Mortality with COVID-19 Infection

Jack Cush, MD

Maternal and fetal outcomes during the COVID-19 pandemic have not been well studied; yet a new retrospective study from Mexico indicates that during the pandemic maternal mortality increased by nearly 57%, with COVID-19 as the cause in 23% of cases.

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RheumNow Podcast – Do More DMARDs Mean More Switching? (9.17.2021)

Jack Cush, MD

Smartphones and diet; COVID-19 and the numbers - reassuring or not, and what about masks?; and do more drugs mean more switching, less persistence, and patient adherence goes up...or down? All this and more news and journal reports in this week's episode.

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Effect of Diet on COVID Outcomes

Jack Cush, MD

A smartphone-based symptom study of COVID-19 patients has shown that a healthy plant-based diet was associated with lower risk and severity of COVID-19, especially amongst those living in areas with higher socioeconomic deprivation.

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Prospective study of 77 RA patients in remission --> vax w/ BNT162b2 (BioNTech-Pfizer) (w/ temp D/C of DMARDs per ACR) found a vaccine-related flare rate of 7/8% (6 pts) w/ 5/6 flares after 2nd dose (2.6 days), resolved w/in 2 wks https://t.co/YOL3YVArvG #RheumNow https://t.co/dxRWhu8CJX

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Dr. John Cush RheumNow ( View Tweet)
Can I get the INFLUENZA and COVID Vaccines together? The CDC says: "YES...both vaccines can be given at the same visit, people should follow the recommended schedule for either vaccine.... ideally get a flu vaccine by the end of October." https://t.co/T49zm6Cxyc

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Dr. John Cush RheumNow ( View Tweet)

New study on #COVID19Vaccine in autoimmune cytopenias 🩸7.4% had clinically significant ⬇️ in counts 🩸 All successfully managed w/steroids & transfusion 🩸 Mild ⬇️ in 10% AIHA and 20% ITP ⭐️Vaccination safe with close monitoring⭐️ https://t.co/qGZe6LiPKz

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AmericanJournalofHematology AjHematology ( View Tweet)

Prospective study of 77 RA patients in remission --> vax w/ BNT162b2 (BioNTech-Pfizer) (w/ temp D/C of DMARDs per ACR) found a vaccine-related flare rate of 7/8% (6 pts) w/ 5/6 flares after 2nd dose (2.6 days), resolved w/in 2 wks https://t.co/YOL3YVS2ne

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Dr. John Cush RheumNow ( View Tweet)

MMWR reports real world vax efficacy in 3,689 adults (21 states) found better results w/ Moderna (93%) than Pfizer (88%) than Janssen (71%). 2 dose mRNA vaccines were more effective than 1 dose Janssen COVID vaccine https://t.co/phmPdB9dTW

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Dr. John Cush RheumNow ( View Tweet)

Maker Trade name Generic PFIZER Comirnaty Pfizer-BioNTech COVID-19 Vaccine FDA approved MODERNA Spikevax Moderna COVID-19 Vaccine - EUA currently J&J (pending) Janssen COVID-19 Vaccine- EUA currently https://t.co/MM7XiSCczl

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Dr. John Cush RheumNow ( View Tweet)

Addendum: Other conditions w/ a 1.2-2 fold higher risk of COVID death (admission) were CKD, hematologic cancer, epilepsy, COPD, CVD, stroke, atrial fibrillation, CHF, thromboembolism, PVD, type 2 diabetes. https://t.co/bbDsb1zLhX

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Dr. John Cush RheumNow ( View Tweet)

Addendum: COVID deaths increased w/ age, deprivation, male, Indian & Pakistanis. Highest risk w/ Down’s syndr (HR 12.7), renal transplant (8.1), sickle cell (7.7), Nursing home (4.1), chemotherapy (4.3), HIV/AIDS (3.3), liver cirrhosis (3), CNS dz (2.6) https://t.co/bbDsb1zLhX

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Dr. John Cush RheumNow ( View Tweet)

Breakthrough infections from UK QResarch database: Among 6.95 million vaccinated, 74.1% recv two vaccine doses, there were 2031 covid-19 deaths & 1929 hosp admissions; ~4.0% deaths & admissions were >14 days after 2nd dose https://t.co/bbDsb1zLhX

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Dr. John Cush RheumNow ( View Tweet)

Analysis of existing #COVID data - as of 7/15/21, 114.9 million adults infected with COVID-19 in US. Overall population immunity (Infx+vax) is 62%, highest in adults >65yrs (77.2%); lowest in children <12 yrs (17.9%) https://t.co/EYiBUaQBLY

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Dr. John Cush RheumNow ( View Tweet)

ICYMI: American College of OBs & GYNS and the Society for Maternal-Fetal Medicine both enthusiastically endorse COVID Vaccination of pregnant women, given the delta variant, low vax rates in Preg women and poor COVID outcomes in preg. https://t.co/AmP5eOEgr3 #RheumNow https://t.co/wXeT1KDCrJ

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Dr. John Cush RheumNow ( View Tweet)
In case you missed it… Breakthrough COVID infection. Breakthrough brilliance in a KOL A must read from Len Calabrese https://t.co/2Ljzau5nBG #RheumNow

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Dr. John Cush RheumNow ( View Tweet)

ICYMI: Probenecid, an OAT3 inhibitor, has inhibitory effects on RNA viruses (influenza, RSV) & decreases ACE2 expression. May have utility in COVID-19 as it was shown to inhibit SARS-CoV-2 replication in animal models https://t.co/MClSjpqpSa #RheumNow

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Dr. John Cush RheumNow ( View Tweet)

Another non stellar result for remdesivir Remdesivir plus standard of care versus standard of care alone for the treatment of patients admitted to hospital with COVID-19 (DisCoVeRy): P3, randomised, controlled, open-label trial ⁦@TheLancetInfDis⁩ https://t.co/kNSNj9RM4K

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Dr Philip Robinson philipcrobinson ( View Tweet)

American College of OBs & GYNS and the Society for Maternal-Fetal Medicine both enthusiastically endorse COVID Vaccination of pregnant women, given the delta variant, low vax rates in Preg women and poor COVID outcomes in preg. https://t.co/AmP5eOEgr3

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Dr. John Cush RheumNow ( View Tweet)

Study of 265 students w/ a positive COVID-19 test looked at 378 close contacts. Infx rates w both persons masked -7.7%, but when unmasked-32.4% (aORs = 4.9;) https://t.co/fYdH33JbWR

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Dr. John Cush RheumNow ( View Tweet)

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