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2022 Rheumatology Year in Review (1-6-2023)
Dr. Jack Cush reviews the best of 2022 in Rheumatology - highlights on new drug indications, breakthrough lupus therapies, new biosimilars and the multivitamin letdown.
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COVID-19 Vaccine Responses in Rheumatic Disease Patients
Nature Reviews Rheumatology features a review of three notable papers that address the impact of SARS-CoV-2 vaccination on people with inflammatory rheumatic disease.
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Vaccine Efficacy in Patients with Seronegative Spondyloarthritis
Vaccine efficacy remains an important and highly discussed topic at this year’s annual meeting given the ongoing COVID-19 global health crisis, current influenza season, and recently published 2022 ACR guidelines for vaccinations in patients with rheumatic and musculoskeletal diseases.
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CDC: Nursing home residents not up to date w/COVID-19 vaccines have 30%–50% higher risk for COVID infx vs those up to date. Betw 2022-23 Those vax had COVID rate of 7.2-15.6/1000pts vs 9.5-18.8/1000 pt in those unvaccinated. https://t.co/Eem2H5AMoN https://t.co/o2ZyPVswZp
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Dr. John Cush RheumNow ( View Tweet)
UK Database 1,955 breakthrough COVID-19 infxs in 54,576 #gout pts compared to 52,468 w/o gout saw more in gout (adj HR 1.24), also w/ more #COVID hospitalizations (adj HR 1.30) & death (1.36), more so in women. Same for unvaccinated https://t.co/596KvupZxi https://t.co/BJJguQBdin
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Dr. John Cush RheumNow ( View Tweet)
Autoimmune Dz may be assoc w/ new-onset Atrial Fibrillation, esp in women. Population-based UK Biobank found significant increases for AFib in Rheumatic fever w/o CVD (HR 1.47), Crohn’ (1.23), UC(1.17), RA (1.39), PAN (1.82), SLE (1.82), PSS (2.32) https://t.co/rpIiztUfg9 https://t.co/FWmLiZ6x1S
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Dr. John Cush RheumNow ( View Tweet)
Should Kids w/ MIS-C get the COVID vaccine? Yes - study of 385 pt > 5 yrs w/ Hx of multisystem inflammatory syndrome showed no serious adverse events after COVID-19 vaccination. The safety profile of COVID-19 vax is same as gen population https://t.co/dr2QBQsMhE? https://t.co/WbsUuYEsez
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Dr. John Cush RheumNow ( View Tweet)
On Wednesday 12/21 the FDA approved tocilizumab (Actemra; 8 mg/kg, 60-min IV infusion ) for hospitalized COVID-19 on steroids, supplemental O2 & req ventilation, or ECMO; 1st MAb approved for COVID-19; Prev EUA issued in June 2021 https://t.co/BswLu4ZY5O https://t.co/7gpPkeoPZ4
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Dr. John Cush RheumNow ( View Tweet)
COVID-19 Vaccine Responses in Rheumatic Disease Patients
Nature Reviews Rheumatology features a review of three notable papers that address the impact of SARS-CoV-2 vaccination on people with inflammatory rheumatic disease.
https://t.co/R9UM3amPRR. https://t.co/WmHyVKdsxw
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Dr. John Cush RheumNow ( View Tweet)
During 2021–22 FLU season, 6% of hosp pedi-influenza pts had SARS-CoV-2 coinfection; these required more respiratory support. Risk of influenza death augmented by not recv vaccination (flu or covid), no antiviral Rx, comorbidities & coinfx w/COVID https://t.co/bfjeClHflW https://t.co/YTOEnNSQQN
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Dr. John Cush RheumNow ( View Tweet)
Recent CDC/MMWR report shows Paxlovid x 5days (including those w/ prior COVID or vaccination), had a 51% lower hospitalization rate within 30 days after diagnosis than those not prescribed Paxlovid. Use it irrespective of vaccination status https://t.co/CBc1VBSDFR https://t.co/EC8QGaFrb3
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Dr. John Cush RheumNow ( View Tweet)
TIME Mag - "Why Masks Still Matter". 1) COVID is still out there; 2) Influenza on the rise. Authors write "With limited yet mixed data, we would be wise to ...err on the side of masking in high risk, indoor crowded public settings..." https://t.co/l8jiTwAdZz https://t.co/0QUKJDOhjs
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Dr. John Cush RheumNow ( View Tweet)
Does Evusheld shield people living with rheumatic diseases?
Dr. Yuz Yusof ( @Yuz6Yusof) discusses three key abstracts from #ACR22 on Evusheld findings.
https://t.co/wYl6Wpd5Fs https://t.co/7T7u4czNOX
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Dr. John Cush RheumNow ( View Tweet)
COVID Highlights
Dr. Leonard Calabrese and Dr. Cassandra Calabrese share highlights on COVID data being presented at #ACR22
https://t.co/DEUykGt8pT https://t.co/sz8GRRGrPH
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Dr. John Cush RheumNow ( View Tweet)
Impact of COVID 19 on Pregnancies in Women with RMD
Dr. Cassy Sims ( @DrCassySims) discusses abstract 0950 at #ACR22.
https://t.co/qbFRV5P3eP https://t.co/cmS4n15L5e
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Dr. John Cush RheumNow ( View Tweet)
Vaccination +/- prior Covid-19, and with either mRNA or vectored DNA vaccines were not associated with AIRD flares. Negative association 21-days after 1st Covid-19 vaccination and no association after 2nd or 3rd doses. Nakafero G Abs#2194 https://t.co/vA8cMNQGkr #ACR22 @RheumNow https://t.co/SZnXejnmYt
Dr. Antoni Chan synovialjoints ( View Tweet)
Problem w antibodies to prevent #COVID19 infection in rheumatic Pts is that they are not as good in variants that are more prominent ex Omicron strains. But should we use in high risk Pts ex long rituximab users? I do in this group. @RheumNow #ACR22 https://t.co/A8soYbg9ZD
Janet Pope Janetbirdope ( View Tweet)
L08 #ACR22 TIX/CIL (Evusheld) in Rheum Pts
157 pts, f/u 154 days
24 breakthrough COVID ifns (15%)
2 pts required hospitalization, rest had mild-mod symptoms
No SAEs (CVD)
@RheumNow
Eric Dein ericdeinmd ( View Tweet)
In a prospective cohort where MTX was withheld for 1 week post COVID vaccine, antibodies higher than other DMARDs which were continued (mostly RTX/MMF).
Good to see more direct data rather than having to extrapolate from flu.
@RheumNow ABST0913 #ACR22
https://t.co/YphKywNJfA
Julian Segan JulianSegan ( View Tweet)
Even young SLE patients are still at high risk of severe COVID:
- in general pop, age is key factor
- in SLE, risk is high across age groups (maybe due to both meds & disease)
- vaccination makes a big diff but SLE pts still at high risk
ABST1591 @CCalabreseDO #ACR22 @RheumNow https://t.co/ra1F79ITn3
David Liew drdavidliew ( View Tweet)
