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RheumNow Podcast – The Bad News That’s Fit to Print (8.21.20)
Dr Jack Cush reviews the news and journal reports from the past week on RheumNow: filgotinib rejection, delays in diagnosis, metformin benefits COVID, Abx and IBD, and UPA beats MTX.
Read ArticleCanakinumab Tapering in Still's Disease
You can reduce - but not stop - canakinumab therapy in patients who are in complete clinical remission in children with systemic juvenile idiopathic arthritis.
Read ArticleNew Criteria for Discoid Lupus
JAMA Dermatology has proposed an initial validation of classification criteria for discoid lupus erythematosus (DLE), primarily for research purposes, but with clinical applicatility.
Read ArticleIncreased Lupus Anticoagulant Activity in COVID-19 Infection
JAMA Network Open reports that after adjusting for inflammation, lupus anticoagulant (LA) is significantly increased (positive) in COVID-19 patients and that LA positivity was associated with incidence risk of thrombotic events.
Read ArticleIs Mortality Improving in Systemic Sclerosis?
Systemic sclerosis (SSc) is a progressive autoimmune disorder that causes premature death, usually from lung, GI, or renal disease. While treatment efforts have been frustrating advances in care may have altered the risk of death according to population data showing that while SSc mortality increased from 1968 through 2000, it has declined since 2001.
Read ArticleRheumNow Podcast - The SARS-CoV-2 Update (8-14-20)
Dr. Jack Cush updates the news and journal articles from the past week on RheumNow.com, with information on enthesitis, nr-Ax-SpA, UAB, Blockbuster Rheum Drugs and use of ACE inhibitors.
Read ArticleRheumNow Podcast - Top 13 Rheumatology Centers (7-31-20)
Dr. Jack Cush reviews the news and TOP 13 list of Best Rheumatology Hospitals.
Read ArticleColchicine Benefits COVID-19 Patients
A proof-of-concept study published in Annals of Rheumatic Disease suggests that colchicine significantly improves COVID-19 outcomes.
Efficacy and safety must be determined in controlled clinical trials.he outbreak of COVID-19 posed the issue of urgently identifying treatment strategies. Colchicine was considered for this purpose based on well-recognised anti-inflammatory effects and potential antiviral properties.
RheumNow Podcast – COVID-19 Responds to Steroids (7.24.20)
Dr. Jack Cush reviews the News and Journal Reports from the past week on RheumNow.com.
Read ArticleSteroids and Tocilizumab in Cytokine Storm Syndrome
A recent study from the Netherlands has shown that patients with severe COVID-19-associated cytokine storm syndrome (CSS) with high dose steroids and tocilizumab had a faster recovery, less need for invasive mechanical ventilation and fewer deaths when compared to CSS patients receiving supportive care only.
They studed COVID-19 patients with CSS, defined as rapid respiratory deterioration plus at least two of the following biomarkers: a) C-reactive protein >100mg/L; b) ferritin >900 µg/L; or c) D-dimer >1500 µg/L.
RECOVERY Trial: Dexamethasone in COVID-19
Inflammatory events following infection with SARS-CoV-2 can often worsen the morbid or mortal outcomes with COVID, yet it has been unclear if glucocorticoids may modulate inflammation-mediated damage and lung injury. The RECOVERY trial reports that dexamethasone (DEX) use lowered 28-day mortality among COVID-19 patients requiring respiratory support.
The RECOVERY trial was performed in the UK and enrolled hospitalized COVID-19 patients who were randomly assigned patients to usual care alone or the addition of oral or intravenous dexamethasone (at a dose of 6 mg once daily) for up to 10 days. The primary outcome was 28-day mortality.
RheumNow Podcast – LTF – Listen to Fauci (7.17.20)
Dr. Jack Cush reviews the news, tweets and journal articles from the past week on RheumNow. Let's dig into this week's 14 highlights.
Anti-Rheumatic Therapies for COVID-19 Infection
Since the onset of the COVID-19 pandemic numerous anti-rheumatic therapies have been proposed as being potentially beneficial. The mechanistic effects of these agents, either presumed antiviral, anti-inflammatory and anti-thrombotic effects, may benefit mitigate the damage seen with COVID-19 infection.
This review will examine the potential benefits and existing evidence for treating suspected or proven COVID-19 infection with antimalarials, inhibitors of interleukin-6 (IL-6) or interleukin-1 (IL-1) Janus kinase (JAK) inhibitors, TNF inhibitors or colchicine. There are many other antirheumatic and immunosuppressive therapies that are in clinical trials that will not be reviewed here including IVIG, rituximab, calcineurin inhibitors (sirolimus, etc.), apremilast, emapalumab (anti-IFN gamma), etc.
Growing Risk of COVID Among Adolescents
The risk COVID-19 infection and mortality in the U.S. has been closely correlated with increasing age. However, recent data suggests that young adults (aged 18–25 years) have shown an increasing risk of COVID-19 infection since the pandemic began in March 2020.
Read ArticleCOVID's Multisystem Inflammatory Syndrome in Children
Two recent reports further characterize the newly described, Kawasaki-like, syndrome affecting children with COVID-19 infections.
The NEJM describes the childhood syndrome as having Kawasaki’s disease, fever, toxic shock syndrome, acute abdominal conditions, and encephalopathy; hence the label Childhood Multisystem Inflammatory Syndrome. The disorder emerged in late April 2020, first in the U.K., and then similar cases were reported from many other countries. The CDC named this multisystem inflammatory syndrome in children (MIS-C).
RheumNow Podcast – Lupus Mortality Declines, But… (6.26.20)
Dr Jack Cush reviews the news and journal articles from the past week on RheumNow.com
Read ArticleACR Outlines Best Practices for Kids With MIS-C
Multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 infection has both similarities and differences with Kawasaki disease, and requires distinct clinical management, according to draft guidance from the American College of Rheumatology (ACR).
Read ArticleRheumNow Podcast – Enough Already with Weaning (6.19.20)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.
Read ArticleCosentyx FDA Approval for Non-Radiographic Axial Spondyloarthritis
Yesterday the FDA approved secukinumab (Cosentyx) for the treatment of patients with active non-radiographic axial spondyloarthritis (nr-axSpA). There are now three agents that are FDA approved for nr-axSpA: certolizumab, ixekizumab and now, secukinumab.
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