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RheumNow Podcast – Don’t Hold the Benlysta, Take the Vaccine (1.22.2021)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com, with more than a dozen items to discuss on this week's podcast.

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COVID Test Antibody

NEJM: Early Combo Monoclonal Antibody Therapy in COVID-19

d Jack Cush, MD

NEJM has published the interim analysis of the REGN-COV2 trial, wherein an antibody cocktail reduced viral loads with less clinical consequences. 

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COVID infection mask

Combo Anti-Spike Protein Antibody for Mild to Moderate COVID-19

d Jack Cush, MD

JAMA has published the BLAZE-1 study, showing significant SARS-CoV-2 viral load reduction at day 11 and less COVID-19 progression when combination anti-spike monoclonal antibody therapy (bamlanivimab and etesevimab) was given to mild to moderate, non-hospitalized COVID-19 patients.

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Aurinia yesterday announced the FDA that the has approved voclosporin (Lupkynis) for Lupus Nephritis. Voclosporin is an oral calcineurin inhibitor to be used in combination with a background immunosuppressives to treat adultswith active lupus nephritis https://t.co/90ba2Iq0eU

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Dr. John Cush RheumNow ( View Tweet)

Today is the PDUFA date wherein the FDA decides the fate of Aurinias calcineurin inhibitor, Voclosporin, use in lupus nephritis. https://t.co/6du61xGrDq https://t.co/2knPWyNmu4

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COVID Vaccine Q & A - Dr Kevin Winthrop Dr. Cush interviews Dr. Kevin Winthrop (OHSU) on the use and caveats to COVID-19 vaccination in patients with rheumatic disease and taking biologic and DMARD therapies https://t.co/EJL6hVLnrp https://t.co/XOHk9T04rx

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MMWR reports 10 cases of anaphylaxis after 4 million doses of Moderna COVID-19 vaccine (2.5 cases per million doses administered). 9/10 occurred within 15 minutes of vaccination. No anaphylaxis-related deaths were reported. https://t.co/lyAVapQH6f

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Dr. John Cush RheumNow ( View Tweet)

Metanalysis of Rituximab use in EGPA (Churg-Strauss) found 19 cohort studies, 8 case series, 18 cases, for a total of 368 EGPA patients. RTX yielded 80% w/ complete or partial remission (w/ more complete responses in pANCA+ pts) https://t.co/PTVLSwCHPv https://t.co/PfjBOoi1S7

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Dr. John Cush RheumNow ( View Tweet)
Seronegativity in RA studied using sera and microarrays from 559 RA (283 ACPA-) found 9 autoAbs w/ >90% specificity for seroneg RA. anti-PTX3 & anti-DUSP11 had best performance w/ sensitivity 38% & specificity 88% https://t.co/HraZg7SQPZ https://t.co/6Z8ebvarVm

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Mortality Risk in Rheumatoid Lung Patients A Medicare claims analysis of rheumatoid arthritis (RA) patients showed that RA-associated interstitial lung disease (RA-ILD) was seen in nearly 5% of patients and was found to increase mortality risks. Read on: https://t.co/RJxDB8tiRu https://t.co/daZppFnteu

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Metanalysis RCTs of Antidepressants in painful conditions (LBP, sciatica, hip/knee OA) shows SNRIs (Cymbalta, Savella, Effexor etc) have a small & not clinically important for effect on back pain. A clinically important effect on OA cannot be excluded https://t.co/lGqeEHtbnK https://t.co/wcta0VVSqp

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QD Clinic - Smoking and RA: The dastardly, nastardly facts of smoking and RA https://t.co/H4jeFIXeGq https://t.co/xWxjzGZWQq

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Dr. John Cush RheumNow ( View Tweet)
In the UK, NICE has recommending ed (to NHS) that filgotinib (Jyseleca) be approved for use in moderate to severe active rheumatoid arthritis (RA).https://t.co/g5zLwIa3MK

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Dr. John Cush RheumNow ( View Tweet)

Don’t hold Benlysta for the COVID19 vaccine! Previous studies have shown that SLE pts on Benlysta (belimumab) still have good antibody response to vaccinations (including Prevnar14, PPSV23, flu and tetanus vaccines). ⁦@RheumNow⁩ https://t.co/4rFdcIKjkT

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k dao KDAO2011 ( View Tweet)

Canadian lupus cohort of 560 SLE pts without myositis at baseline. Over time, only 5 pts developed myositis (after mean 8.5 yrs). Incidence = 1.05 per 1000 PYs. Arthritis, Raynauds, -Sm Abs were common, but only non-Whites had increased risk of myositis. https://t.co/fzWhUADjMz

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NEW QD Clinic Differential Dx Myalgias & Arthralgias https://t.co/ozawoe6RMO

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Denosumab inhibiting osteolysis? 22 pts undergoing revision THR surgery for osteolysis, 10 Rx w/ denosumab had 83% fewer osteoclasts @ osteolysis membrane–bone interface. Proof concept: DEN may have osteoclast effects at implant interface https://t.co/dJ06rk0SR3

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Ehlers-Danlos Syndrome pts have higher association with GI conditions (IBS, etc OR =3.57), POTS & Autonomic dysfunction (OR=4.4), food allergy (OR= 3.9), CV complications (OR 6.1; MV dx, aortic aneurysm), longer hospitalizations (OR= 1.76) https://t.co/noobvrx0cQ

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Though provoking piece by Dr. Len Calabrese in Healio,He references Drs. Schett and Scher writing in Nature Reviews Rheumatology on KOLs. Both articles are about reflection on what we do, how we do it, what motivates us. Good Reads https://t.co/HDlFRVJq1a https://t.co/CtqqiZuxwo

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Swedish Armed Forces study suggests the least fit are at greatest risk for developing psoriasis later inlife. From 1968 -2005 1,886,542 military recruits were followed mean 31 yrs. Low CV fitness showed higher rate of psoriasis (HR 1.35) and PsA (HR 1.44) https://t.co/52zTjMM24y

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