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Outcomes of COVID-19 in Patients with Rheumatoid Arthritis
Patients with rheumatic diseases – requiring lifelong immunosuppressants— are at high risk for respiratory and viral infections. Over the past decade, an armamentarium of biologic and targeted therapies has led to better control of disease activity in patients with rheumatoid arthritis. Whether these patients, especially those receiving newer biological and targeted therapies such as JAK inhibitors, are at an increased risk of severe COVID-19 outcomes remains uncertain.
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Experts (Drs. M Clowse, Sammaratino) limit mAb TNFi 1 month b/f delivery or extend dosing. But, they do dose again for flares. Risk for infection is low based on the PIANO registry. Postpartum, they restart the meds w/in 1 week (vag delivery), 2 weeks C/S @rheumnow #pregnancy
TheDaoIndex KDAO2011 ( View Tweet)
In ANCA-associated vasculitis, does reverse seroconverting (ANCA+➡️ANCA-) make a difference?
relapse - no
ESRD - no
death - no
Don't measure serial ANCAs for prognosis
(no diff MPO/PR3, RTX/CYC)
target trial emulation @BrighamWomens @MGHrheumatology #ACR21 ABST0419 @RheumNow https://t.co/rLkTY0ul8f
David Liew drdavidliew ( View Tweet)
Either we need to review the Yearly PAP cervical screening in SLE women or work hard to improve patient awareness. Suspect the latter as time between tests was over 4 years late 😱 and 2.7% developed cancer #ACR21 #Abstr0133 @RheumNow https://t.co/wm01MfoFjf https://t.co/blD8WafZsE
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#ACR21 Abst #0269: VA study of AutoAbs and CVD risk
⭐️Anti-malondialdehyde acetaldehyde (anti-MAA) shown to associate w/ CVD risk in non-RA pt
Findings: RF, CCP, anti-IgG anti-MAA, anti-IgM anti-MAA (not IgA) associated with ⬆️ CVD death
https://t.co/WRBh673u8T @Rheumnow #ACRbest
Links:
Eric Dein ericdeinmd ( View Tweet)
Dr. M Clowse (on HCQ during pregnancy):
👉All pregnant women get HCQ 400 mg/day regardless of how big they are (she does not dose based on mg/kg/d)
👉with maternal metabolism/volume distrib, levels are low.
#ACR21 @rheumnow #pregnancy @drbags71 https://t.co/dZtFLdKOvk
TheDaoIndex KDAO2011 ( View Tweet)
Industry Press Releases - BMS, Abbvie, UCB, Janssen
The pharmaceutical companies will feature the results of their pivotal clinical trials and data analyses at #ACR21.
https://t.co/RZwtACFZq7 https://t.co/guBG6PDVfp
Links:
Dr. John Cush RheumNow ( View Tweet)
RheumNow’s expanded coverage of the #ACR21 annual meeting is sponsored in part by @bmsnews, @JanssenUS, @Novartis. All content chosen by RheumNow and its Faculty.
Dr. John Cush RheumNow ( View Tweet)
@DoctorYasmin: "Where do people go when their doctors don't believe them?". Communicate the unknown and listen. @DrDavidKarp: "It all begins with empathy." Listen to the patient, and you can avoid them from seeking misinformation to fill in gaps #ACR21 @rheumnow https://t.co/nBBDxl2L1D
Eric Dein ericdeinmd ( View Tweet)
“It all begins with empathy!” Dr. Karp regarding difficult unknown/long haul COVID19 symptoms in our patients. #ACR21 @RheumNow
Dr. Rachel Tate uptoTate ( View Tweet)
Interesting twist to an #ACR21 keynote lecture: Q&A!👏👏@DoctorYasmin
She even eloquently explained the etymology of crisis-the point in a pt's illness where they might rapidly deteriorate or recover, an inflection point (so relevant now) 👉to a new BETTER normal
@RheumNow https://t.co/UMKIC1tNos
sheila RHEUMarampa ( View Tweet)
How do you separate the misinformation in this ecosystem of cash hungry platforms? Check out
@DoctorYasmin's upcoming book: "What the Fact" for tools on how to handle sifting through the nonsense! #ACR21 @RheumNow https://t.co/oroHMakVT6
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
@DoctorYasmin emphasizes our focus should be on:
1 Moral injury, burnout & mental health for providers
2. Providers should make concerted efforts to learn how to communicate in the public space
3. How to institute cultural change
@DrDavidKarp #ACR21 @rheumnow https://t.co/YH7tDeaki3
TheDaoIndex KDAO2011 ( View Tweet)
"We should be thinking about preparedness...if this happens again, what might our role be, how might we best care for patients"
Brilliant keynote from fellow @Cambridge_Uni alumna @DoctorYasmin #ACR21! Inspiring to hear about her journey through medicine (and beyond)! @RheumNow https://t.co/AyoP1S3zmL
Mrinalini Dey DrMiniDey ( View Tweet)
Wonderful keynote lecture by @DoctorYasmin on The Covidization of Rheumatology: What Will or Won’t Change Beyond the COVID-19 Pandemic #ACR21 @RheumNow
Akhil Sood MD AkhilSoodMD ( View Tweet)
Full circle for VEXAS, from breaking at last years ACR to making the year in review for #ACR21 @RheumNow https://t.co/1iGNPvyzQi
Richard Conway RichardPAConway ( View Tweet)
🙋I cannot be alone in saying I do not #ACR21 @RheumNow https://t.co/AxKK03TJHY
Richard Conway RichardPAConway ( View Tweet)
A quick recap slide on VEXAS syndrome presentation. #ACR21 @RheumNow @petercgrayson https://t.co/4x8hBEFWg2
swethaann23 swethaann23 ( View Tweet)
Still like one of those people like me who struggles with the acronym #VEXAS? Here we go!
1⃣Vacuoles, 2⃣E1 enzyme, 3⃣X-linked, 4⃣autoinflammatory, 5⃣somatic
Year in review at #ACR21 @RheumNow
https://t.co/gMgFPF6NcS
Bella Mehta bella_mehta ( View Tweet)
"How can we institute cultural change?" -@DoctorYasmin asks everyone to weigh in.
@DrDavidKarp @ACRhem #ACR21 @rheumnow @PeterHotez @AWIRGROUP #MedTwitter #RheumTwitter
[Quote tweet your answer here]
TheDaoIndex KDAO2011 ( View Tweet)