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New Onset Rheumatic Disorders with COVID-19 Infection

d Jack Cush, MD

The journal Cells has published a review of new rheumatic disorders following COVID-19 infection. Rheumatologists have infrequently noted such events and wondered what is the true incidence or range of possible manifestations.

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Clinical Practice Guidelines for Multisystem Inflammatory Syndrome in Children

d Jack Cush, MD

Multisystem inflammatory syndrome in children (MIS-C) is new and serious complication of COVID-19 that preferentially affects adolescents. A review of proposed management guidelines is compiled in this report, suggesting a unified approach to therapeutic management of MIS-C.

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Autoantibody Associations in Systemic Sclerosis

d Jack Cush, MD

Analysis of two large cohorts of systemic sclerosis (SSc) patients shows a signfiicant minority of patients to have autoantibodies typical of rheumatoid erosive arthrits, but their presence in SSc patients was associated with unique manifestations of SSc. 

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Spesolimab, an IL-36 Blocker, in Pustular Psoriasis

d Jack Cush, MD

The NEJM has published the results of a phase 2 randomized trial showing that the use of an interleukin-36 receptor inhibitor, spesolimab, resulted in rapid improvement of generalized pustular psoriasis (at 1 week), but that adverse events and infections were of concern with 12 weeks of foll

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Safety of COVID-19 Vaccines in Rheumatic Patients

d Jack Cush, MD

Since the introduction of COVID-19 vaccines in January 2021, rheumatologists have fully advocated the protective benefits of their use - yet many have rarely noted flares and reactive side effects worrisome to patients.  Now a multinational study shows that the use of COVID vaccination in rheumatic and musculoskeletal disease is safe, well-tolerated with very rare serious adverse events.

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Clinical Practice Guidelines for Multisystem Inflammatory Syndrome in Children Multisystem inflammatory syndrome in children (MIS-C) is new and serious complication of COVID-19 that preferentially affects adolescents. Read more : https://t.co/3VXU7vEkb7 https://t.co/bWUseG9ogf

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Infectious mimics of #RA include viruses (Parvo B19, HBV, HCV, HIV, Chikungunya alphaviruses) mycobacterial infections (Poncet's dz, TB, leprosy), bacterial arthritis, brucellosis and Lyme disease. https://t.co/COjPWU8sC5

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Collagen Ab induced arthritis (animal model for RA) may also evolve into a model of axial spondyloarthritis as once induced, they also developed spinal lesions similar to those found in AxSpA. https://t.co/y1J9fNiFQd

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@ACRheum guidance from 2/2021 recc holding HCQ in pts with #COVID19. Are you doing this? We need updated guidances with #Omicron @rheum_cat @LCalabreseDO @CCalabreseDO @RADoctor @RheumNow @JYazdanyMD

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ASK CUSH ANYTHING! Have a Rheumatology question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/7q5sMQuIHj https://t.co/ksCCvzdxka

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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/CenvwXiYPV https://t.co/ocBDIiF5IB

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New slides available for download! Should I start a podcast? These slides are your notes on how to start a podcast. How and why, with a few suggestions thrown in. https://t.co/Q0owuZdJ2c https://t.co/rHuwKPkH7G

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There have been reports of COVID-19 vaccination causing adult-onset Still’s dz onset. Now a case of AOSD, given the BNT162b2 vax and developing Macrophage activation syndrome w/ ferritin levels of 136,680 µg/l https://t.co/caKef9BGDR

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Safety of COVID-19 Vaccines in Rheumatic Patients A multinational study shows that the use of COVID vaccination in rheumatic and musculoskeletal disease (I-RMD) is safe, well-tolerated with very rare serious adverse events (AEs). https://t.co/d30zbfa0f8 https://t.co/OM6GzAzTvQ

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Cosentyx (secukinumab) was FDA approved for use in pediatric psoriatic arthritis & enthesitis-related arthritis, based on results of the ph III JUNIPERA study. Dosing based on weight (SEC 75 mg sc if 15-50kg; SEC 150 mg sc if 50 kg or more) https://t.co/1nv3iJ7EJ3

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Does COVID Vax reduce adolescent MIS-C risk? In France 77% of teens recv COVID Vaccine by 10/2021. From Sept-Oct 2021,107 MIS-C kids were hospitalized in France; 31% were eligible but not vaccinated. MIS-C risk dropped 91% (0.09) after 1st first vax dose https://t.co/mF0L2VnEoi https://t.co/R33n1FCN3X

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Of 173 autoimmune inflammatory rheumatic Dz pts w/ respiratory Sx, 46 had Pneumocystis jirovecii. Higher risk of PJP w/ high-dose steroids, recent immunosuppressives, combo w/ CsA, hx of chr lung dz, high LDH, ground glass CXR https://t.co/P8KtC2Hab8

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Study of biologic/ts DMARD switching in 8,398 axial spondyloarthritis pts from 5 Nordic registries showed a low rate of multiple switches (refractory?) over 3 years; ≥3 DMARDs (8%), ≥4 (3%) & ≥ 5 (1%); more w/ women, comorbiditiy & psoriasis https://t.co/ZQDvl6AaZz

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Best of 2021:Hydroxychloroquine related hyperpigmentation appears as blue/ black discoloration of skin or mucosa, occurs in 7-30%; Recent report says ~5%; Risk factors include steroids, bruising, anti-coagulants & trauma - theyr slow to resolve if you D/C https://t.co/IJDolwNyDx

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Best of 2021: Comparison of oral and parenteral MTX shows oral MTX in RA is non inferior to subcutaneous MTX treatment (in 640 RA pts) with regard to disease activity, but oral MTX had fewer adverse events than SC ( 41% vs 52%, p= 0.005). https://t.co/4RB7SxuGx7

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