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RWCS 2021

RWCS Highlights - Day 1

d Rachel Tate, DO

The 2021 Rheumatology Winter Clinical Symposium launched yesterday as a hybrid meeting. As always, this conference lends itself to data for the practical clinician. Here are my pearls about new developments in RA, checkpoint inhibitors and IV IgG taken from several sessions presented on Day 1.

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COVID vaccine vials

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The American College of Rheumatology has published a draft guidance on the use of COVID-19 vaccination in rheumatic disease and musculoskeletal disease patients, based on the efforts of the North American Task force.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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309 RA pts from the Preconception Counseling in Active RA (PreCARA) cohort were treated according to a modified T2T approach, 188 children were born. 47% of pts were on a TNFi during Preg; 75% were in LDAremission before PREG but 90% by 3rd trimester https://t.co/eLffxrH0UV

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Preprint from UK trial shows tocilizumab efficacy in COVID-19. 2022 TCZ vs 2094 usual care pts (also on dexamethasone), in hospitalized pts on ventilators. 28 day mortality was 29% on TCZ Vs 33% with usual care - TCZ had 23% incr probability of discharge https://t.co/Curd6W20qK https://t.co/0TbhJYh5vM

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Upadacitinib works very well in ankylosing spondylitis. Will JAKs soon be approved in #AS @RWCSmtg @JointMD https://t.co/09KFo3mYJs
Dr. John Cush RheumNow ( View Tweet)
Tofacitinib shown to work very well in ankylosing spondylitis. @RWCSmtg @JointMD https://t.co/r1yIL96HyQ
Dr. John Cush RheumNow ( View Tweet)
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
Dr. John Cush RheumNow ( View Tweet)
Eranercept works in nonrad AxSpA @RWCSmtg @JointMD https://t.co/PFTqNj6R3s
Dr. John Cush RheumNow ( View Tweet)
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
Dr. John Cush RheumNow ( View Tweet)
From RWCS, AI and machine learning is effective and accurate at taxiing and scoring done films in #AS @RWCSmtg @JointMD https://t.co/PVmeyx1d4r
Dr. John Cush RheumNow ( View Tweet)
Dr Eric Ruderman shows x-ray progression is different/lower in non radiographic AxSpA @RWCSmtg https://t.co/tqI3xKhDuJ
Dr. John Cush RheumNow ( View Tweet)
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
Dr. John Cush RheumNow ( View Tweet)
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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Dr. John Cush RheumNow ( View Tweet)
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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Dr. John Cush RheumNow ( View Tweet)
QD Clinic - Sawtooth Steroid Taper How I Taper Steroids - the Sawtooth way https://t.co/PNMV3Pjbxc

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Dr. John Cush RheumNow ( View Tweet)

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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Dr. John Cush RheumNow ( View Tweet)
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