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RheumNow Podcast - Rheumatic Patients with COVID (5.29.20)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.

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kneepain3.jpg (keep)

Targeting the Wnt Pathway Fails in OA

d RheumNow

The Wnt pathway modulator lorecivivint failed to meet the primary endpoint in a phase IIa study for knee osteoarthritis (OA), but showed promise in certain patient subgroups, researchers reported.

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Cytokine storm

TNR Grand Rounds - Cytokine Storm Syndromes

d Jack Cush, MD

This week's Tuesday Nite Rheumatology featured Dr Randy Cron from the University of Alabama - Birmingham as he spoke and took questions on the immunology, immunopathogenesis and treatment of Cytokine Storm Syndrome, especially as they relate to COVID-19 and rheumatic disease patients. The program was moderated by Dr. Jack Cush.

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DCVAS study of 1338 ANCA-Assoc Vasculitis (#AAV) pts showed AAV onset after age 65yrs had a 2 fold higher mortality (HR 2.06) and higher damage indices and grear risk of systemic, CNS, CV and renal disease (compared to onset <65 yrs) https://t.co/wUCm6D2K6l

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Dr. John Cush RheumNow ( View Tweet)

Check my updated virtual video joint exam for rheumatologists - Video here> https://t.co/ZXEUKcw5mb or listen to the podcast>> https://t.co/XSHWuwxJ9L https://t.co/0GtL22HxWp

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Dr. John Cush RheumNow ( View Tweet)
RheumNow Poidcast is up - Rheumatic Patients with COVID (5.29.20). BTK in RA, AAV skin, more HCQ, JAK safety, Resp failure in Rheum pts. Watch it on RheumNow>> https://t.co/M6SWTA3Leo Listen on iTunes>> https://t.co/FHJv01AAbC or on Soundcloud>> https://t.co/Kp5nxuryVT

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Dr. John Cush RheumNow ( View Tweet)

Today we announced the submission of a New Drug Application to the U.S. Food & Drug Administration for voclosporin as a potential treatment for #lupusnephritis. More in today's release: https://t.co/G5fZLnx60l https://t.co/5VmKceLEB3

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Aurinia Pharmaceuticals Inc. AuriniaPharma ( View Tweet)
Young woman with SLE previously only arthritis, serology, Raynauds. Presented with fever, SOB during #pandemic Broad differential. Not always #COVID__19 @RheumNow https://t.co/jrmP3xHzcu
Janet Pope Janetbirdope ( View Tweet)
Phase 3 baricitinib trials (2890 pts) there were 215 prior/occult HBV infection (HbcAb+) and 8 (3.7%) had a positive HBV DNA+ (≥29 IU/mL). Four met the definition of reactivation and 3 required antiviral therapy = check HBV serologies with JAK inhib use https://t.co/9xGIu5hzNh

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Dr. John Cush RheumNow ( View Tweet)

TNR Grand Rounds on "Cytokine Storm Syndromes" features a lecture and Q&A with Dr. Randy Cron - watch it here>> https://t.co/1CZ1YOY5W3 or listen on iTunes>> https://t.co/FHJv01AAbC or SoundCloud Podcast>> https://t.co/G0EuWMGTdW https://t.co/z57pBUhAKn

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Dr. John Cush RheumNow ( View Tweet)
UPI quotes Dr. Tony Fauci stating (about hydroxychloroquine) "The scientific data is really quite evident now about the lack of efficacy". Yesterday France and other countries have banned the use of HCQ to treat COVID. https://t.co/G0EuWMGTdW

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Dr. John Cush RheumNow ( View Tweet)

Great NY Times article on 30+ years of an adversarial friendship between Dr. Tony Fauci and AIDS activist Larry Kramer (who recently passed away). Keen that adversaries can still be on the same side, pushing for change differently https://t.co/lnfk6fXfF2

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Dr. John Cush RheumNow ( View Tweet)

BTK inhib (fenbrutinib-FEN) effective in #RA. In a 12 wk RCT, 480 MTX-IR pts Rx either PBO, adalimumab or FEN (50 mg or 150 mg/d). ACR50 resp was PBO 15%; ADA 36%; FEN 50mg 18%, 150 qd 28%, 200 mg bid 35%. FEM NO effx on myeloid & B cell biomarkers. https://t.co/JIb4FtiOQG

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Dr. John Cush RheumNow ( View Tweet)

NEJM reports no difference between 5d and 10d course of Remdesivir in severe Covid-19 not requiring mechanical ventilation; but this trial did not include a placebo control https://t.co/mxAR2qQzPa

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Dr. John Cush RheumNow ( View Tweet)

CORRONA registry compared Triple DMARD (MSH) to TNF/MTX Rx; MSH is infrequently used; Triple DMARD pts were older, longer Dz duration, less Dz activity, more CA & comorbidities. Comparatively MSH had more Discontinuations & less likely to get to LDAS https://t.co/WSHgzrfcIn

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Dr. John Cush RheumNow ( View Tweet)

Case-control study of risk factors for [rheumatic use] hydroxychloroquine retinopathy: cumulative dose, duration of intake, creatinine clearance and geographical origin sign^ in multivariate analysis, what is driving the geo finding? genetics? https://t.co/2NGaZiqpsc @RheumJnl

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Dr Philip Robinson philipcrobinson ( View Tweet)

NEW RESEARCH: Repeat ANA testing after a negative result has low utility and results in high cost https://t.co/Zfc2vqRue1 #LancetRheumatology https://t.co/N9iHfdNYix

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The Lancet Rheumatology TheLancetRheum ( View Tweet)
Proud of this amazing collaboration with @zach_wallace_md: 52 rheumatic cases vs. 104 non-rheumatic comparators, all infected with COVID-19. Rheum cases had 3-fold risk of mechanical ventilation @BrighamResearch @MGHMedicine https://t.co/nBXe78i4JU

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Jeff Sparks jeffsparks ( View Tweet)

Skin is often involved w/ ANCA+ vasculitis - 1184 AAV pt study shows skin involvement in 34% GPA; 28% MPA & 47% EGPA. Common are petechiae/purpura pruritus, urticaria, and maculopapular rash. AAV w/ skin Sxs have more systemic dz (GN, alveolar hemorrhage) https://t.co/zL7a38aDIt

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Dr. John Cush RheumNow ( View Tweet)

Studies have shown a higher risk of gout w/ obstructive Sleep Apnea;a recent study shows higher risk (OR 1.86) disappears (OR 1.05) after adjusting for BMI, CHF, DM, diuretics, and renal dz. Gout associates with comorbidities, including obesity and OSA https://t.co/39Wen3uydM

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Dr. John Cush RheumNow ( View Tweet)

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