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RheumNow Podcast – Pounds of Prevention (3.5.2021)

Jack Cush, MD

Dr. Jack Cush reviews and discusses nearly a dozen news reports and journal articles from the past week on RheumNow.com.

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Covid lung pneumonia corona (keep)

Baricitinib Therapy in Covid-19 Pneumonia

Jack Cush, MD

The NEJM has published the results of the ACCT-2 Study,  a double-blind, randomized, placebo-controlled trial evaluating baricitinib, an inhibitor of Janus kinase 1 (JAK1) and JAK2, plus remdesivir in hospitalized adults with Covid-19. The primary outcome was the time to recovery.

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Telemedicine.MD.Computer.phone (keep)

Paucity of Effectiveness Research on Telemedicine in RA

Jack Cush, MD

A systematic review of telehealth in delivering equivalent care in RA patients demonstrates there is limited evidence that virtual RA care is equivalent to conventional face-to-face care. Despite current widespread use, there is a great need for credible well-designed research that will address comparable patient outcomes, implementation strategies and long‐term health system consequences. 

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IL-6 IL6 cells cytokine

NEJM: Interleukin-6 Inhibition in Critically-Ill COVID-19

Jack Cush, MD

The pendulum and jury are wavering with regard to the benefits of interleukin-6 receptor antagonists in COVID-19; the current NEJM reports the results of a study favoring such biologic therapy in in critically ill COVID-19 patients.

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RWCS Highlights - Day 3

Rachel Tate, DO

Day 3 report from the 2021 RWCS meeting in Maui (and virtually) includes pearls from the PsA 2020 Year in Review; fact vs. fiction on evidence based medicine: diet and rheumatic diseases; hot topics in allergy/immunology; and pediatric rheumatology highlights.

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COVID vaccine vials

ACR Promotes New COVID-19 Vaccine Clinical Guidance for Rheumatic Patients

Jack Cush, MD

The American College of Rheumatology has published a draft guidance on the use of COVID-19 vaccination in rheumatic disease and musculoskeletal disease patients, based on the efforts of the North American Task force. The document provides guidance to rheumatology providers on the use of the COVID-19 vaccine and the associated management of RMD patients around the time of vaccination. Here is a summary of the recommendations.

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GSKs RCT showed otilimab (investigational anti-GM-CSF Ab) in severe COVID-19, was not superior to SOC for the primary endpoint - the proportion alive and free of respiratory failure at 28 days (but was effective in pts >70 yrs (65% vs 46%) https://t.co/OHvWGGlgKv

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Dr. John Cush RheumNow ( View Tweet)

News Feature: NEJM: Interleukin-6 Inhibition in Critically-Ill COVID-19 https://t.co/IrKnTlPDpK https://t.co/8topsI3nQN

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Dr. John Cush RheumNow ( View Tweet)
Top February Tweet: ACR Task Force published guidelines on RMD drug use w/ COVID vaccines. My views: 1. I agree, no change most DMARD, biologics 2. I disagree; I would NOT hold Orencia, I would NOT hold JAKi 3. I disagree: I would not hold MTX https://t.co/uSPfvJB8EC https://t.co/unOY1jvzTJ

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Dr. John Cush RheumNow ( View Tweet)
Its sill not SAFE! Avoid congregate settings! CDC report shows among 81 who participated in indoor high-intensity exercise classes - 68% developed COVID-19. 40% with COVID-19 attended class on day Sxs began. Most (76%) wore masks infrequently https://t.co/KLZauJUupN

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Dr. John Cush RheumNow ( View Tweet)

In Israel (as of Feb 2021) 84% of those ≥70 years and 10% for <50 years have received 2 doses of the COVID Vaccine; as such the need for mechanical ventilation in the elderly has declined 67% with the implementation of COVID vaccines. https://t.co/9Qnv72QYUS

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Dr. John Cush RheumNow ( View Tweet)

My Experience as a COVID19 Vaccine Trial Participant https://t.co/ILfXLUL8IZ

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Dr. John Cush RheumNow ( View Tweet)

Email Survey study of HSS rheumatic pts 7,094 responded 1,547 were women (18-50yrs) & 61 (4%) were pregnant during COVID. COVID prevalence was similar in PREG vs nonPREG (8% vs.9% ), PREG COVID pts had shorter Sxs, more loss taste/smell. https://t.co/4HDuXbZVrs

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Dr. John Cush RheumNow ( View Tweet)

Common mucocutaneous findings in 35 kids w/ MIS-C & COVID: 1) conjunctival injection (21), palmoplantar erythema (18), lip hyperemia (17), periorbital erythema/edema (7), strawberry tongue (8), & malar erythema (6) https://t.co/mcSOXtXaEh

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Dr. John Cush RheumNow ( View Tweet)

Could the PEG portion be responsible for IgE and non-IgE mediated COVID vaccine reactions? Both Moderna and Pfizer use the same 2000kd PEG for stability of the lipid nanoparticle. (Recall Miralax and PEG reactions...) Dr. A Postolova #RWCS2021 #RWCS @RWCSmtg @RheumNow https://t.co/ALXvR2h21z
Dr. Rachel Tate uptoTate ( View Tweet)
Vaccinated COVID-19 pts appear less contagious; report from Israel - among 650,000 received two-doses of Pfizer vaccine, 2,897 later tested positive for COVID-19, but nasal swab samples showed 4-fold less virus - hinting protection https://t.co/UBE4q6aE63

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Dr. John Cush RheumNow ( View Tweet)

ACR Promotes New COVID-19 Vaccine Clinical Guidance for Rheumatic Patients The ACR has published a draft guidance on the use of COVID-19 vaccination in RMD patients, based on the efforts of the North American Task Force. https://t.co/uSPfvJB8EC https://t.co/9bwBdtHw5e

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Dr. John Cush RheumNow ( View Tweet)
Preprint from UK trial shows tocilizumab efficacy in COVID-19. 2022 TCZ vs 2094 usual care pts (also on dexamethasone), in hospitalized pts on ventilators. 28 day mortality was 29% on TCZ Vs 33% with usual care - TCZ had 23% incr probability of discharge https://t.co/Curd6W20qK https://t.co/0TbhJYh5vM

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Dr. John Cush RheumNow ( View Tweet)
Comorbidity and Drugs Drive COVID-19 Severity and Survival in Rheumatic Disease While comorbidities are associated with severe COVID-19 infection, it appears they also influence severity and survival in RMD according to a French cohort study. https://t.co/8rh1YvtqoE https://t.co/dxVGkdTPKg

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Dr. John Cush RheumNow ( View Tweet)
Congrats to ACR Task Force who published guidelines on RMD drug use w/ COVID vaccines. My views on their recs: 1. I agree, no change most DMARD, biologics 2. I disagree; I would NOT hold Orencia, I would NOT hold JAKi 3. I disagree: I would not hold MTX https://t.co/uSPfvJB8EC https://t.co/SznUJosmpo

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Dr. John Cush RheumNow ( View Tweet)
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