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HHS, FDA & CDC Joint Recommendation on COVID Booster

d FDA

Today, public health and medical experts from the U.S. Department of Health and Human Services (HHS) released the following statement on the Administration’s plan for COVID-19 booster shots for the American people.

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Tocilizumab in Refractory Skin and Joint Scleroderma

d Jack Cush, MD

The interleukin-6 inhibitor, tocilizumab (TCZ), was studied in a cohort of difficult systemic sclerosis (SSc)  and was shown to be effective in refractory joint and skin disease with good long-term retention rates and disease stabilization.

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Inflammatory Arthritis Impairs Male Fertility

d Jack Cush, MD

A new study in Annals of Rheumatic Disease shows that inflammatory arthritis (IA) may impair male fertility, especially during the peak reproductive age when lower fertility rates, higher childlessness rates and more fertility problems were seen.

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ACR Update on Tocilizumab Shortages

d ACR

The American College of Rheumatology (ACR) is actively engaged with the FDA Center for Drug Evaluation and Research (CDER) drug shortage team as they work with the manufacturer to resolve current shortages of tocilizumab (Actemra).

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Non-Serious Infection Risk with Biologics in RA

d Jack Cush, MD

Nonserious infections (NSI) comprise the bulk of all infections seen with biologic therapies; new data from British Society for Rheumatology Biologics Register for Rheumatoid Arthritis shows that while NSI are more common than serious infections, the predictors of NSI are the same as serious infections.

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Free Video from the NEJM - Mobility Assessment in Older Adults. Useful in assessing geriatric patients, frailty, risk of falls (4 stage balance test) and functional impairment. 7:36 long. https://t.co/zZcDDOg12U

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Dr. John Cush RheumNow ( View Tweet)

Belimumab in Pregnancy? a study of 13 pregnancies in 13 pts, mean age 38 yrs.. There were 11 live births, 1 case omphalitis (recovered w Abx) . No fetal anomalies found. 6 pts (46%) w/ Hx of recurrent pregnancy loss, four had live births on BEL https://t.co/FJJhepa25M

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Dr. John Cush RheumNow ( View Tweet)

Acute CPPD arthritis -1697 pts compared w/ 6503 controls. CPPD pts were older (74 yrs), 57% female, 81% White; & assoc w/ OA (OR 3.1), male (OR 1.3), RA (2.1), gout (2.8), PPI (1.9), diuretics (~1.5). CPPD less likely in Blacks vs Whites (OR 0.47) https://t.co/U22jBmjWXm

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#RA & Driving studied w/ installed auto sensor-based instrumentation - 23 controls compared to 33 RA pts (1292 driving hrs): shows RA & worsening Dz severity assoc w/ poor vehicle control; Braking/accelerating & steering variability liked to CDAI levels. https://t.co/umXGAbuicz https://t.co/oN2tTXpAtE

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Dr. John Cush RheumNow ( View Tweet)
Spirometry study in 2,008 #RA patients - compared to controls, RA has a higher risk of restrictive Lung dz (OR 1.36, 95%CI 1.21,1.52) and obstructive LD (OR 1.21, 95%CI 1.07,1.37) independent of confounders like smoking https://t.co/UWViAZL6PO https://t.co/9OBz5ROKhw

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Bone marrow cell vacuolation in VEXAS https://t.co/j0rGngjJZA

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US News & World Report Ranks Best Rheumatology Hospitals Did your hospital make the list? https://t.co/DgoE0On7So https://t.co/B9NXJ8W4xl

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Dr. John Cush RheumNow ( View Tweet)
Important read re:G6PD testing prior to HCQ Rare & not assoc w/hemolytic anemia in this cohort, but only 11 pts with G6PDH deficiency I'm v. skeptical of G6PD screening; cost (no HCQ in SLE) could easily be worse than benefit (avoiding hemolytic anemia) Do you routinely test? https://t.co/HI2PuF1Xq9
Mike Putman EBRheum ( View Tweet)
Check for APAs and LAC in SLE pts with hemolytic anemia https://t.co/hlGfnq89Pz

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k dao KDAO2011 ( View Tweet)

Oligoarticular Versus Polyarticular Psoriatic Arthritis: A Longitudinal Study Showing Similar Characteristics https://t.co/bIPdfUIL5S via @docguide 39% oligo progress to poly - what about response to therapy - likely the same?

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Peter Nash drpnash ( View Tweet)

Using data from Framingham Study, 347 pt w/ Widespread Pain (WP) compared to 2117 without. WP was associated with an increased risk of all-cause dementia (HR: 1.43), Alzheimer's (HR: 1.47) and stroke risk (HR: 1.29). https://t.co/S1CS01zNkJ

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Dr. John Cush RheumNow ( View Tweet)

Sporadic reports of anakinra use in COVID-19 infection has hinted is potential; now a metanalysis shows that the use of anakinra may reduce the mortality risk in patients admitted to hospital with moderate to severe COVID-19 pneumonia. https://t.co/VBxg9fQmt0 https://t.co/ARX2C0WRJ1

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Dr. John Cush RheumNow ( View Tweet)
Analysis of 7815 RA patients (female, 85%) w/ 340 H. Zoster events (309 pts). HZ rates were lower in men vs women 8.5 vs 11 HZ/1000 Pt-Yrs. Zoser Risk factors: incr HAQ (OR 1.51), MTX use (1.58), and biologic use (1.88) https://t.co/p0MTlwgJ8g Conclusions

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Among a cohort of first-degree relatives of patients with rheumatoid arthritis (RA), certain patient characteristics, as well as symptoms, helped predict a possible increased risk for developing the disease, U.K. researchers reported. https://t.co/7geaJDO8O8 https://t.co/opIu4gXxin

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Dr. John Cush RheumNow ( View Tweet)
https://t.co/lRr1EsoADU EULAR 2021: Still’s Disease Highlights Sponsored by Novartis Medical Affairs Listen to a discussion of medical experts discuss insights from independently selected abstracts in Still’s disease.

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Dr. John Cush RheumNow ( View Tweet)

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