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Slow Steroid Tapering Succeeds in SLE

d MedPage Today

Gradual withdrawal of glucocorticoids was successful among patients with systemic lupus erythematosus (SLE) after 2 years of clinically quiescent disease, without an increased likelihood of flares, Canadian researchers reported.

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fetus,defect,baby,malformation

Potential Birth Defects with Hydroxychloroquine

d Jack Cush, MD

Hydroxychloroquine (HCQ) is one of the safest meds used in rheumatology, but there is new claims data suggesting a small increase in the risk of malformations associated with first-trimester HCQ use.

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back, LBP, spine, AS

Is Pre-Clinical Spondyloarthritis a Real Risk?

d Jack Cush, MD

A study of first-degree relatives (FDRs) of HLA-B27-positive axial spondyloarthritis (axSpA) patients shows clinical or imaging features of spondyloarthritis in up to 32% subjects, regardless of HLA-B27 status.

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Rare Myocarditis Risk following COVID-19 Vaccine

d CDC/MMWR

MMWR review of the risk of myocarditis and pericarditis reports a June 23, 2021 recommendation by the Advisory Committee on Immunization Practices that the benefits of COVID-19 vaccination clearly outweighed the risks of myocarditis after vaccination. 

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NHANES survey study shows adult psoriasis in the US was 3.0% (7.5 million adults). Psoriasis was most common in non-Hispanic White individuals, and the prevalence of psoriasis has not significantly changed since 2003 in the US. https://t.co/3yrlPu1GGi

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Rare Myocarditis Risk following COVID-19 Vaccine https://t.co/Q9QGhTTKvC https://t.co/dTOR9sZ3iP

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FDA & CDC joint statement: Those who are "fully vaccinated do not need a booster shot at this time". People who are not vaccinated remain at risk. Virtually all COVID-19 hospitalizations and deaths are among those who are unvaccinated. https://t.co/miqEJE4wgC

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Doximity Telemedicine report estimates 20% of US medical visits via telehealth; ~$29 billion of medical services in 2020. Top 10 telemedicine specialites: 1 Endocrinology 2 Rheumatology 3 GI 4 Renal 5 Cardiology 6 GU 7 Neuro 8 Geriatrics 9 Hem/Onc 10 Pulm https://t.co/a8WBEHmNzs

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6/24/21 FDA has granted emergency use authorization (EUA) for Actemra (tocilizumab) us in treating hospitalized COVID-19 (adults and kids) patients on steroids and who require, supplemental oxygen, mechanical ventilation, or ECMO https://t.co/YAVfbykcti

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Modest IL-6 mAb benefit w/ COVID. Metanalysis 27 RCTs & 10 930 hosp COVID pts shows 28D all-cause mortality lower w/ IL-6i (vs usual care.PBO) (OR 0.86), better w/ steroids (OR 0.78). Mortality 22% w/ IL-6i vs 25% usual care. https://t.co/rTLjGMMe2g https://t.co/nz1sbKlk2E

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How should anti-IL-6 mAb therapy be used in COVID-19 infection? 1. w/ corticosteroids 2. Early/severe pts: 3. Hospitalized on O2, but not ventilated https://t.co/S6DT0Fsjow https://t.co/oeM8EgZk8n

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Lit review shows there are few good studies patients on the management of hospitalised gout pts. No studies have tested strategies designed to prevent gout re-admissions/flares. Better prospective studies of ULT use by hosp gout is needed https://t.co/OVkMTepa5y

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HCQ prolongs SLE survival. Case–control study 6241 incident SLE pts compared 290 SLE dead to 502 alive controls. HCQ reduced all-cause mortality by 50% (aOR 0.50; .30–0.82) but HCQ stoppers had incr mortality (aOR 2.47) - sick stopper effect? https://t.co/JIeTJaDVPk

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185 Lupus pts undergoing renal transplant for ESKD saw good outcomes. Pt survival = 88%, 82%, 78% & 67% (@ 1,3,5,10 yrs). Graft survival was 93%, 89%, 87% & 89% (@ 1,3,5,10 yrs). Immunosuppressive use was protective & only 2 cases of recurrent LN seen https://t.co/xgFYskeX0a

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Metanalysis of 33 clinical trials show that corticosteroids are anaglesic, especially in 1st 3 mos (mean drop VAS pain -12mm); after that benefit wanes to -8mm @3-6 mos and -6mm (95% CI, -10mm, -2mm) after  6 mos. https://t.co/IKZhqqwhPO

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Top June Tweet: Pain Persists in RA, Even Without Inflammation One-third of patients with rheumatoid arthritis had unacceptably high levels of pain 5 years after diagnosis, often despite low levels of inflammation, Swedish researchers found. https://t.co/K8zf1pE9jM https://t.co/XwdCXnktQN

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ICYMI: RheumNow Podcast – Tofacitinib Safety Concerns https://t.co/3Q5OvHRht5 https://t.co/JLFuj5tETw

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Are you subscribed to RheumNow? Benefits include delivery of new articles right to your inbox, access to downloads and more. Register today. https://t.co/riyAnrRHhX

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Tofacitinib shown to work very well in ankylosing spondylitis. @RWCSmtg @JointMD https://t.co/bx5FS9BSDZ
Dr. John Cush RheumNow ( View Tweet)
Throwback Tweet: Hello 2021 and new drug price hikes - on average a 4.2% hike in over 500 drugs (past years saw an avg hike ~5%). Increases include Cosentyx 7%, Humira & Rinvoq 7.4%, Orencia 4.5%, Taltz 5%, Actemra 3%, Benlysta 5%, Xeljanz 4.9% & Cimzia 4%

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