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Clinical Trial Boom or Bust in Severe COVID-19

d Jack Cush, MD

A number of recently published clinical trials are further defining the efficacy and outcomes of tocilizumab or remdesivir in treating SARs-CoV-2 infection.



Remdesivir

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depression oh no HA

Biologic Use for Arthritis Linked With Depression and Anxiety

d Jack Cush, MD

In a recent study of patients with inflammatory rheumatic diseases, the initiation of a biologic treatment or switching to another biologic was associated with an increased likelihood of the use of antidepressants and anxiolytics, reported Petros P. Sfikakis, MD, of the National and Kapodistrian University of Athens, and colleagues in RMD Open: Rheumatic & Musculoskeletal Diseases.

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Outpatient Visits Return to Pre-COVID Rates

d Jack Cush, MD

The COVID-19 pandemic dramatically impacted outpatient care - numbers, scope, quality, etc, but a recent study suggests that while COVID has changed the scope of care, the numbers of outpatient visits have risen to near pre-pandemic numbers.

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FDA approved its 1st drug to treat COVID-19 - the antiviral drug Veklury (remdesivir) for for acute care treatment of COVID-19 requiring hospitalization. Approval based on 3 clinical trials showing clinical improvement, but no change in mortality rates. https://t.co/IrA7oKMuGq

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Study from China finds that hemophagocytic lymphohistiocytosis (HLH) was a rare (4.2%) but fatal (77.8%) complication in myositis patients (DM, PM, or CADM). Risk factors include baseline Dz activity, worsening ILD and infection https://t.co/QDN1DYzl5p

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How are you consuming Virtual CME Rheumatology conferences

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Study from NY shows that Death rates from COVID-19 have dropped (in hospitalized pts) from a high of 27% down to 3%. Partly because a younger, healthier are now getting infected, arriving @ hospital w/ less-severe Sxs. Also improved COVID medical care https://t.co/8aFuVHUDjY

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#LTF Listen to Fauci

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Korea National Health databased looked at Fracture rates in RA patients taking TNFis, abatacept, or tocilizumab betw 2002 to 2016. They found no difference in Fx risk related to the biologic taken. https://t.co/W2dWWseXTc

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QD Clinic - Triage Rheumatology - Lessons from the clinic. Dr. Jack Cush discusses What constitutes urgent, emergent and Patients you should see https://t.co/0mKvbB9Knv https://t.co/YYN7nOum9t

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QD Video - I'm Not Stupid (IgG4) - Lessons from the clinic. Dr. Jack Cush discusses an IgG4 case and the power of discussion https://t.co/RDIVEeyqxW

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NEW RESEARCH: Abatacept in the treatment of diffuse cutaneous #SystemicSclerosis; clinically meaningful improvements in mRSS and other outcome measures were observed when patients transitioned to open-label #abatacept treatment https://t.co/tDSo3u8hAY #LancetRheumatology https://t.co/Nc8XYc1URW

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The Lancet Rheumatology TheLancetRheum ( View Tweet)
Congratulations to Dr. Sherine Gabriel on being elected to the National Academy of Medicine - one of the highest honors in medicine. She is president and James A. Campbell Distinguished Professor, and chief academic officer at Rush University in Chicago https://t.co/16lnBZjZWk

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NEJM reports that obese pts having bariatric surgery have a longer life expectancy (less death HR 0.77; 0.68-0.87; P<0.001) than pts treated w/ nonsurgical, usual obesity care. They live 3 yrs longer (than controls) but 5 yrs shorter than gen Population https://t.co/nBa6IuKAyX

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Empty out your medicine cabinets. Sat Oct 24th is DEA "TAKE BACK" day. Dispose of unused, unwanted, controlled drugs, narcotics, e-cigarettes. Theyll take your tablets, capsules, patches, pens, liquids (BUT NOT syringes, sharps, illegal drugs) Where? https://t.co/oDMYHl3mgI

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Study of seropositivity in RA patients in the RISE (43,581) registry & Marketscan pts (1185) showed ICD10 Coding with M05 had a sensitivity = 0.73- 0.76, & PPV = 0.82 -0.84 for seropositive RA. Good but does that mean Ya'll are miscoding 25% of your RA pts?https://t.co/Wc6FQeQEHA

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Swedish population studied CV risk, studied gout. Among 22,057, 910 (4.1%) developed incident gout by 27.5 yrs w/ 5 Clusters: C1 no/few comorb; C2 had CKD; C3 CV dz; C4 obesity, dyslipidemia; C5 DM, HTN, diuretics. 86% of incident gout came from C1 & C4 https://t.co/TeMdXx5qU1

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Lilly has announced results of Phase 2 SERENITY trial showing the IL-23 inhibitor, mirikizumab, was more effective than PBO at week 12 (PRO and endoscopic outcomes) in moderate to severe active Crohn's disease. Efficacy continued out to week 52 https://t.co/n8Mdeonmas

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SELECT CHOICE, H2H study of UPA vs ABA in TNF-IR RA pts; UPA had better DAS28-CRP & ABA had better Safety outcomes; Which would you use?

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Not sure why this study was done...BUT... Tociiizumab was studied in 104 hand osteoarthritis and after 12 weeks, TCZ was equivalent to Placebo in achieving100mm VAS pain reduction (-9.9 vs -7.9), but TCZ had numerically more adverse events https://t.co/NYujNQbjvm

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