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Hold Myophenolate or Not with COVID-19 Vaccination?

d Jack Cush, MD

While the American College of Rheumatology recommends holding mycophenolate (MMF) in rheumatic and musculoskeletal diseases patients (RMD) receiving COVID-19 vaccines, there is limited data on such an approach. A recent cohort study of RMD patients showed that holding MMF yielded higher antibody responses than continuing MMF.

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COVAX Registry: Safety of COVID-19 Vaccines in Rheum Patients

d Jack Cush, MD

The EULAR Coronavirus Vaccine (COVAX) physician-reported registry has shown that the use of COVID-19 vaccines in people with inflammatory/autoimmune rheumatic and musculoskeletal disease (I-RMD) is effective, safe, and well tolerated.

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Psoriasis, arms, PsA

KEEPSaKe-1 Trial in Psoriatic Arthritis - IL-23 Inhibition is Effective

d Jack Cush, MD

The results of the KEEPSaKE-1 study in psoriatic arthritis (PsA) has been published and shows that risankizumab (RIZ), an IL-23 inhibitor, showed significant clinical improvements when given to active PsA patients who failed or were intolerant to ≥1 csDMARD.

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What Can JIA Patients Expect 18 Years In?

d MedPage Today

Follow-up in a Scandinavian cohort of juvenile idiopathic arthritis (JIA) patients that began in 1997-2000 revealed a number of surprises, a new study indicated.

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Biologic Treatment of Primary Sjogrens with Ianalumab

d Jack Cush, MD

Clinical trials generally fail in Sjögren's syndrome; but now a study shows that a biologic B cell inhibitor, ianalumab, met its primary endpoint with a dose-related decrease in disease activity (measured by ESSDAI) at week 24.

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BEAT LUPUS - Belimumab after Rituximab in SLE

d Jack Cush, MD

A recent trial published in Annals of Internal Medicine analyzed the effects of B-cell depletion (rituximab) followed by B-cell suppression (belimumab) and showed effective lowering of anti-dsDNA titers and and fewer severe flare in patients with systemic lupus erythematosus (SLE).

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JAMA cohort study of 5.9 million VA pts and with & without gout ( 556 521)-gout pts had higher rates of lower extremity amputation (HR 1.59), than those without gout. This was assoc w/ poor uric acid control (>7), but not urate lowering therapy. https://t.co/KiM3IBCCp4

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Global Burden of Disease Study shows that globally, from 1990 to 2019, the age-standardized incidence rate (ASIR) of hip osteoarthritis increased from 17.02 per 100,000 persons to 18.70 per 100,000 persons https://t.co/OJOnkAw1Dy

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JAMA study shows that, compared with usual care, colchicine did not significantly reduce mechanical ventilation or 28-day mortality in patients hospitalized with COVID-19 pneumonia (HR 0.83; 95% CI, 0.67-1.02; P = .08). https://t.co/6dRd6gnkjc

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Dr. John Cush RheumNow ( View Tweet)

NEJM: A 14-year-old boy was admitted to this hospital because of fatigue, fever, joint pain, abdominal cramping, and diarrhea. Start w/ Sore, throat, then polyarthritis (knees, Shoul), fever 39.4C. Very high WBC, CRP & lipase. Whats the Dx?

Dr. John Cush RheumNow ( View Tweet)

Biomarker study of 21 systemic juvenile idiopathic arthritis (sJIA) shows you can differentiate between active & inactive disease. From 69 biomarkers, these were predictive: IL-6, MMP1, S100A12 (p < 0.0001), HMGB1; but IL-18 elevated in both groups! https://t.co/m2yXTITzwY

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Single center comparison of pts with MAS vs malignancy assoc. HLH (mHLH) - overall MAS had less hepatomegaly (0 v 25%), double platelet #s (50 v 29Kµ/L), but lower sIL-2R (6814 vs. 27,972.0) and less mortality (22 v 44%, p=0.18). https://t.co/NGIaPTU0yT

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Dr. John Cush RheumNow ( View Tweet)

Register for RheumNow Live, March 19-20, 2022. You can attend RheumNow Live in person in Irving, Texas - or, the comfort of your own home or office. You can also receive CME credit! https://t.co/fYyV75vAWm https://t.co/zOpCbBrzHJ

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New podcast available for download. 2021 Rheumatology Year in Review https://t.co/0Lpo0IUBHp https://t.co/ysdwmQjeaS

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There were significantly fewer FDA advisory committee meetings in 2021 (n=10), down dramatically from 35 in 2012, 29 in 2018. Nonetheless the FDA did approve 50 new drugs (NDA) in 2021. https://t.co/rSzHkIMEfg

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Dr. John Cush RheumNow ( View Tweet)

Patients on biologics are NOT at higher risk for COVID-19 infx. Retrospective matched cohort study compared 7631 Biologic Rx pts to 74910 matched cohort with equal Infx & death rates. COVID infx assoc w/ age, minorities, more comorbidities https://t.co/GxmgWIbgSo

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Duloxetine added to usual analgesics failed to improve pain in 132 hip or knee OA pts by WOMAC pain scores: 1) Dulox + usual care vs 2) Usual care showed no diff in pain at 3 mos or 12 mos. https://t.co/9gR2PNVrPl

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Good (long) open read review of Imaging in NPSLE (CNS lupus); mainly showing there is no SPECIFIC CNS imaging finding for NPSLE. Rather imaging (CT, MRI) done to r/o other pathology. PRES, PML, Vasculopathy, White matter lesions https://t.co/baUp6kjsKr

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Dr. John Cush RheumNow ( View Tweet)

Study of subcutaneous ianalumab in patients with primary Sjögren's syndrome met primary objective, showing dose-related decrease in disease activity (ESSDAI) at week 24: randomised, double-blind, placebo-controlled trial. https://t.co/NqdDWqpX2g https://t.co/PSxSRx28fM

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The Lancet TheLancet ( View Tweet)
My patient measures morning stiffness in his joints by coffee units. Today, it’s 3 ☕️- an equivalent of 1 hour. #rheumatology

TheDaoIndex KDAO2011 ( View Tweet)

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