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Believing is Doing (1.21.2022)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com. These reports are about better outcomes in Lupus; fewer Gout flares with T2T and the power of belief. 

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3rd Vaccine Dose May Benefit ANCA-Associated Vasculitis Patients

d Jack Cush, MD

ARD has publish a prospective, multicenter, observational study of vaccination outcomes in antineutrophil cytoplasmic antibodies associated vasculitis (AAV) patients, showing that AAV patients may not be adequately protected after standard two-dose COVID-19 vaccination, but that a third

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Herpes Zoster Vaccination in Immunocompromised Adults

d Jack Cush, MD

The CDC's Advisory Committee on Immunization Practices (ACIP) recently recommended and approved two doses of the recombinant zoster vaccine (RZV, AKA Shingrix) for prevention of herpes zoster and complications in immunodeficient or immunosuppressed adults aged ≥19 years.

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Referral Rules for At-Risk Inflammatory Arthritis

d Jack Cush, MD

A prospective primary care study of patients at-risk for inflammatory arthritis (IA) showed that progression to IA was most likely in those with high anti-CCP antibody titers levels and involvement of the hands/feet/ IA.

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Who is Your Glue? Surely you have used or heard of “<the person> who was the glue that held the family together”. Read on… https://t.co/CRaWDQaZvk https://t.co/q8KFcxzzDG

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Dr. John Cush RheumNow ( View Tweet)
Referral Rules for At-Risk Inflammatory Arthritis https://t.co/p1sBNSmWF5 https://t.co/tk29UNPYdi

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Dr. John Cush RheumNow ( View Tweet)
ONE MILLION DOWNLOADS! We are excited to announce Dr.Cush and the RheumNow podcast recently hit one million downloads! Thank you to all of our listeners-we appreciate you coming back week after week. Find us each week where ever you get your podcasts. https://t.co/AOJCMGZClJ https://t.co/3ImftCnqzw

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The next generation of lupus therapies (esp in lupus nephritis) - belimumab, voclosporin , anifrolumab, obinutuzumab. Better trial designs, better organ endpoints, but yet these trials/results are limited by the high dose steroids in play.... https://t.co/48D9rI9EEH

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Dr. John Cush RheumNow ( View Tweet)

How's the United States doing on boosters? Trailing a long list of countries, including Serbia, Slovenia, and Lithuania @OurWorldInData https://t.co/cOCVoyuqT3
Eric Topol EricTopol ( View Tweet)
UTSW Rheum Grand Rounds New and concerning: sJIA associated lung disease - rare and associated w/ pulmonary HTN, alveolar proteinosis, high mortality. Unique features: clubbing, eosinophilia, TCZ anaphylaxis, Trisomy 21. Most were Rx w/ IL-1 > IL-6 inhibition @UTSWRheum https://t.co/aJaPurDSmJ
Dr. John Cush RheumNow ( View Tweet)
UTSW Rheum Grand Rounds - Dr. Nigrovic shows the efficacy of long acting IL-1 inhibition (canakinumab) and IL-6 (tocilizumab) in systemic JIA patients @UTSWRheum https://t.co/XdG8pAq1c4
Dr. John Cush RheumNow ( View Tweet)
UTSW Rheum Grand Rounds Treating STill's (sJIA) - early early use of anakinra yields best results (in remission and off steroids) - 91% if Anakinra started within the first 3 mos @UTSWRheum https://t.co/neozpYhJtM
Dr. John Cush RheumNow ( View Tweet)
UTSW Rheum Grand Rounds MAS occurs in 2-8% of Systemic JIA pts and has a high mortality (<40%); It is more frequent w/ onset in Years 1-4. Treatment - steroids, anakinra, etoposide or CsA & Rx infxn if present. Oh...dont stop the anakinra! @UTSWRheum https://t.co/09uQm3LURC
Dr. John Cush RheumNow ( View Tweet)
UTSW Rheum Grand Rounds IL-18 levels are elevated in systemic JIA, MAS and AOSD @UTSWRheum https://t.co/pIYKf4pods
Dr. John Cush RheumNow ( View Tweet)
Dr. Peter Nigrovic asserts the division between pediatric and adult arthritis is senseless and has no firm biologic basis. Instead we should consider pts as sero- positive or negative, Systemci or Spondyloarthropathy. @UTSWRheum https://t.co/zx5oQmUQ6Y
Dr. John Cush RheumNow ( View Tweet)
van Vollenhoven et al strategies onT2T in SLE 1) Choose a Target; treat, monitor, adjust 2) LLDAS & DORIS remission are good targets 3) T2T trials needed w/ current Rx & new biologics & sm molecules 4) LLDAS & DORIS as outcomes in clinical trials https://t.co/aTq398iaSD https://t.co/yWlp4vY7kh

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Dr. John Cush RheumNow ( View Tweet)
UTSW Rheum Grand Rounds with Dr. Peter Nigrovic on systemic JIA in children and adults; yes, its the same disease with the same features. @UTSWRheum https://t.co/C7eBFjnDIi
Dr. John Cush RheumNow ( View Tweet)
Network metanalysis (28 RCTs, 12 504 pts) of Biologics & small molecules therapy in active ulcerative colitis. Upadacitinib 45 mg qd ranked 1st (RR 0.73) vs PBO, infliximab 5 mg/kg & 10 mg/kg ranked 2nd & 3rd. UPA > TNFi at remission. https://t.co/PPNkfXiJSL

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Dr. John Cush RheumNow ( View Tweet)

UCB announced top-line interim analysis results from their Phase 3 "BE MOBILE 1" study, that demonstrated the efficacy of bimekizumab, a dual IL-17A and F inhibitor, in adults with active non-radiographic axial spondyloarthritis (nr-axSpA). https://t.co/FylgQ30Dva https://t.co/XJ4y0U60hu

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Dr. John Cush RheumNow ( View Tweet)
How Bad and How Far? CDC says to date, in the USA, there have been 6,715,937 COVID cases and 850,575 deaths from COVID-19. A total of 249,393,487 (75.1%) have recv at least one VAX dose, 209,312,770 (63%) fully VAX, 38.7% had a booster dose https://t.co/M9fYWL80ae

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