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ACR Promotes New COVID-19 Vaccine Clinical Guidance for Rheumatic Patients

d Jack Cush, MD

The American College of Rheumatology has published a draft guidance on the use of COVID-19 vaccination in rheumatic disease and musculoskeletal disease patients, based on the efforts of the North American Task force. The document provides guidance to rheumatology providers on the use of the COVID-19 vaccine and the associated management of RMD patients around the time of vaccination. Here is a summary of the recommendations.

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gene signature RNA

Synovial Tissue Signature Guiding Targeted IL-6 Therapy in RA

d Jack Cush, MD

RNA sequencing and classification of RA subsets has proven useful. RNA sequencing-based stratification of RA synovial tissue showed stronger associations with clinical responses compared with histopathological classification. Additionally, for patients with low or absent B-cell lineage expression signature in synovial tissue, tocilizumab is more effective than rituximab.

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Tofacitinib shown to work very well in ankylosing spondylitis. @RWCSmtg @JointMD https://t.co/r1yIL96HyQ
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But.... Etanercept was not effective in a small study of "pre-axSpA"(not having MRI SI or Elevated CRP. Low level responses in this study @RWCSmtg @JointMD https://t.co/ofIbByefMH
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Eranercept works in nonrad AxSpA @RWCSmtg @JointMD https://t.co/PFTqNj6R3s
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TICOSPA,. Right control in axSpA didn't work so well, even though the TV group water twice as likely to get advanced therapies @RWCSmtg @JointMD https://t.co/Jm9vHAPwCN
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From RWCS, AI and machine learning is effective and accurate at taxiing and scoring done films in #AS @RWCSmtg @JointMD https://t.co/PVmeyx1d4r
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Dr Eric Ruderman shows x-ray progression is different/lower in non radiographic AxSpA @RWCSmtg https://t.co/tqI3xKhDuJ
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Dr Eric Ruderman shows when pts are referred by MDs, vs self referred, they are more likely to have AxSpA (40 percent). Lectures from RWCS @RWCSmtg https://t.co/mRtMictVpq
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QD Clinic - Surgery Rules for DMARDs & Biologics Patient & Surgeon instructions prior to surgery https://t.co/AFSdpnxp54

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NEJM: Mechanics hands - 37 yoM w/ 14 mos of painful, thickened, cracked skin on his fingertips. Had LG fevers, weakness and labs showed CK 20K, ANA/RF neg, but +Jo-1 & +SSA, Chest CT shows ILD. Whats the Dx? how do you treat? read here... https://t.co/bkCI3SUXNh

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Comorbidity and Drugs Drive COVID-19 Severity and Survival in Rheumatic Disease While comorbidities are associated with severe COVID-19 infection, it appears they also influence severity and survival in RMD according to a French cohort study. https://t.co/8rh1YvtqoE https://t.co/dxVGkdTPKg

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Synovial Tissue Signature Guiding Targeted IL-6 Therapy in RA RNA sequencing-based stratification of rheumatoid arthritis synovial tissue showed stronger associations with clinical responses compared with histopathological classification. https://t.co/VZJuoZ3b5a https://t.co/QxDlnrrywE

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Congrats to ACR Task Force who published guidelines on RMD drug use w/ COVID vaccines. My views on their recs: 1. I agree, no change most DMARD, biologics 2. I disagree; I would NOT hold Orencia, I would NOT hold JAKi 3. I disagree: I would not hold MTX https://t.co/uSPfvJB8EC https://t.co/SznUJosmpo

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RheumNow Podcast – Tofacitinib Safety Concerns https://t.co/rqNoiLB3xr https://t.co/rmlw2T0Cif

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QD Clinic - Sawtooth Steroid Taper How I Taper Steroids - the Sawtooth way https://t.co/PNMV3Pjbxc

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NSAIDs in Osteoarthritis: Study Suggests Need for New Look Knee osteoarthritis (OA) patients using NSAIDs showed greater loss of medial minimum joint space width than did others taking other drugs, registry data indicated. https://t.co/KNbAnNOkva https://t.co/s9mMmAR6TD

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IVIg in MIS-C Among children with multisystem inflammatory syndrome (MIS-C), treatment with IVIG and methylprednisolone vs IVIG alone was associated with a more favorable fever course. https://t.co/iCyJd3bbao https://t.co/edgVLpMP5a

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Danish Cohort study of 5310 cutaneous LE or SLE pts between 1995-2014 (7-8 yrs F/U and 40.724 PYs) shows an overall increased cancer risk for CLE (SIR 1.35)and SLE (1.45), esp a 3-4 fold increased risk for NHL, hematological, pancreatic and lung cancers https://t.co/0FialHXVvb

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We are excited to announce that Dr. Eric Ruderman ( @JointMD) will be speaking on advancing treatments in psoriatic arthritis at RheumNow Live, March 20-21. There's still time to sign up. https://t.co/vJlU0Z3Q3x https://t.co/T0V8JIygyA

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