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In difficult times, it's reassuring to reflect on the similarities that bring us together. In the case of the EULAR and ACR COVID19 guidelines as discussed at #EULAR2020 by Drs.
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This week's Tuesday Nite Rheumatology featured Dr Jonathan Kay (U Mass) who gave an update on Biosimilars and took questions the subject. The program was moderated by Dr. Jack Cush.
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Gianfresco et al have published the first peer-reviewed analysis of COVID-19 infected, rheumatic disease patients entered into the Rheumatology Global Alliance registry; showing that a) rheumatic disease patient can be infected with COVID-19, b) that DMARD and biologic use has no apparent effect on outcomes and c) steroid increase and TNF inhibitor decrease the odds of hospitalization.
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Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.
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This week's Tuesday Nite Rheumatology featured Dr Randy Cron from the University of Alabama - Birmingham as he spoke and took questions on the immunology, immunopathogenesis and treatment of Cytokine Storm Syndrome, especially as they relate to COVID-19 and rheumatic disease patients. The program was moderated by Dr. Jack Cush.
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Anakinra was studied in 29 COVID(+) patients with respiratory distress and high inflammatory markers (CRP or ferritin) and compared to non-anakinra patients, those on anakinra had better survival (90% vs. 56% ;p=0·009) and greater improvements in CRP and pulmonary function (72% vs 50%) compared to controls at day 21.
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An Italian study examined the outcomes in adult onset Still's disease (AOSD) based on whether they received early or delayed treatment with anakinra (ANK).
A total of 141 AOSD patients were retrospectively studied.
David Liew
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Behcet's ulcers can be a real pain.
I've heard pentoxifylline gel be discussed before, here's some early data to back it up (need bigger trial).
Tastes terrible, though - so maybe this?
https://t.co/TrSlIKdWX3
(or a commercial prep might solve it)
SAT0260 #EULAR2020 @RheumNow https://t.co/lvDY39ZbIH
k dao
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#EULAR2020 Recc for irAEs w/ICI:
1. GC's ok, goal<10 mg/d, any csDMARD, bDMARD (TNFi/IL-6),🚫ABT xcept life-threatening myositis
2. Myositis beware bulbar signs: dysphagia, dysarthria, dysphonia: stop ICIs,⬆️GC, IVIG/PE
3. Don't test autoAbs b/f ICI Rx
https://t.co/P5jDgnjK94
Janet Pope
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Don’t forget significant fibrosis with ILD has +RCT with nintedanib INBUILD study. Lots of buzz of RA ILD where MTX is OK, TNFi may have more ILD than other bDMARDs, biomatkers KL-6 @eular_org OP0038 #EULAR2020 @CRASCRRheum https://t.co/OihF3LmNYQ
Dr. John Cush
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14 pts refractory AOSD pts (Yamaguchi+) showed a good response to usual doses of tofacitinib. 7/14 complete remission, 6/14 partial remission & 1 relapse w/ pred reduction. May work by reducing reducing IL-6, IL-10, IFN-γ, IFN-α, GM-CSF, neutrophils. https://t.co/rUNoxJdDi5
Dr. John Cush
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Anakinra studied in COVID(+) ARDS (nonICU) pts w/ high CRP L or ferritin; 29 high dose Anakinra vs 17 controls. At day 21, more survival with anakinra 90% vs. Controls 56% (p=0·009). Anakinra also more improved CRP+resp function (72 vs 50%) https://t.co/wxjlQG44Oc
Dr. John Cush
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Inzomelid, a selective, orall small molecule inhibitor of the NLRP3 inflammasome, has been tested in a phase I trial of CAPS (Cryopyrin-Associated Periodic Syndrome) https://t.co/8gO63xO9bC
Dr. John Cush
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Hyper IgD syndrome. Dr. Dan Kastner #RNL2020 https://t.co/PF5TxDzvdt
Dr. John Cush
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Features of TRAPS. Episodes last 4 to 6 weeks. Amyloid in 10 to 15%. Dr. Dan Kastner #RNL2020 https://t.co/E3CjPa7EVA
Dr. John Cush
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Key features of FMF Dr. Dan Kastner #RNL2020 https://t.co/8BmXxRMvEi
Dr. John Cush
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5 known inflammasomes and what activates them Dr. Hal Hoffman #RNL2020 https://t.co/3qxs1c13YN
Dr. John Cush
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Diseases associated with NLRP3 mutations Dr Hal Hoffman #RNL2020 https://t.co/pN2c2LhjJe
Dr. John Cush
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CAPS, best outcomes with triple therapy that includes Apheresis. Dr Compton #Utsw Rheum Grand Rounds https://t.co/MVesTmSNQK
Dr. John Cush
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Criteria for CAPS. Dr. Compton #Utsw Rheum Grand Rounds https://t.co/tdVWhMEII3
