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Boston and Wuhan Report Rheum COVID Patients at Risk for Respiratory Failure

d Jack Cush, MD

Two current reports from Boston and Wuhan describe cohorts of COVID-19 (+) rheumatic disease patients who generally do well but appear to have a higher risk of pulmonary involvement.

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Hydroxychloroquine Improves Survival in Lupus

d Jack Cush, MD

Hydroxychloroquine (HCQ) has dominated the news in recent weeks, because of poor outcomes reported when used in COVID patients. Yet, a recent report reaffirms what rheumatologists have known for years - that HCQ use is associated with better outcomes in systemic lupus erythematosus, including survival.  

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Low Risk of COVID-19 Pneumonia in Rheumatic Patients

d Jack Cush, MD

A current letter in the Annals of Rheumatic Disease details the rheumatic disease patient cohort outcomes from the University of Siena, Italy showing only 2 cases of COVID-19 among 859 patients treated with tsDMARDs and bDMARDs.

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Again, Antimalarial Use Fails to Benefit COVID

d Jack Cush, MD

Today Lancet reported the results of another retrospective trial showing that hydroxychloroquine or chloroquine, alone or with a macrolide antibioitic, offered no additional benefits to COVID-19 patients, but was associated with higher rates of mortality and arrhythmia.

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RheumNow Podcast - Preaching to the Choir (5.22.20)

d Jack Cush, MD

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

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Outcomes of Critically-Ill COVID Patients in NYC

d Jack Cush, MD

Lancet has reported COVID outcomes from NewYork-Presbyterian hospitals in NYC during March 2020 showing high rates of hospitalization, ICU admission, mechanical ventilation and death. 

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Be sure to catch tonights 8pm EST Grand Rounds - Cytokine Storm Syndrome given by Dr. Randy Cron (UAB) part of the Tues Nite Rheumatology seriies. Go here to register (this is for rheums) https://t.co/RtugDyTBRX

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Dr. John Cush RheumNow ( View Tweet)

Metanalysis of 15 studies & 552,019 pts with RA shows the risk of diabetes to be significantly reduced in RA patients on HCQ (HR 0.61), methotrexate (HR 0.81), TNFi (HR 0.63), but increased with glucocorticoids (HR 1.46 < 10 mg; HR 2.25 for > 10 mg) https://t.co/gULTBtSvYU

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Dr. John Cush RheumNow ( View Tweet)

10 FALSE reasons for not wearing a mask - https://t.co/psGrN4iYMs Please wear a mask out of concern and care for others !!

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Dr. John Cush RheumNow ( View Tweet)

Well Being Trust (WBT) reports that there are 151,964 deaths from alcohol, drugs, and suicide last year. In less than 3 mos, COVID-19 will kill over 100,000 Americans. WBT estimates that COVID could cause between 27,000-68,000 deaths of despair. https://t.co/yIf1yrzkbr

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Dr. John Cush RheumNow ( View Tweet)

Gilead announced phase 2/3 trial results of their JAK1 inhibitor, filgotinib, showing 200 mg qd (not 100 mg qd) dose was effective in ulcerative colitis (SELECTION study) with higher remission rates at weeks 10 (vs PBO); at wk 28 both 100mg and 200mg were superior to PBO

Dr. John Cush RheumNow ( View Tweet)

Do your part. Show respect. Wear a mask.

Andrew Cuomo NYGovCuomo ( View Tweet)

Aicardi-Goutières syndr - inherited early-onset disorders w/ CNS decline & autoimmunity; developmental decline, encephalopathy, weakness, spasticity, autoimmunity autoantibodies, Chilblains, gene defects inTREX1, RNASEH2A, RNASEH2B, RNASEH2C, SAMHD1 https://t.co/p1W5uHVXmQ

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Dr. John Cush RheumNow ( View Tweet)

14 pts refractory AOSD pts (Yamaguchi+) showed a good response to usual doses of tofacitinib. 7/14 complete remission, 6/14 partial remission & 1 relapse w/ pred reduction. May work by reducing reducing IL-6, IL-10, IFN-γ, IFN-α, GM-CSF, neutrophils. https://t.co/rUNoxJdDi5

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Dr. John Cush RheumNow ( View Tweet)

Case report in Annals Internal Med shows efficacy of tocilizumab in Cytokine Storm Syndrome; 51-yo renal transplant COVID+ pt developed multiorgan failure, cytopenias, CRP 262 mg/L, ferritin 52005 - failed MMF, DEX, tacrolimus- turned around w/ TCZ 8mg/kg https://t.co/MMNQGB9SA7

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Dr. John Cush RheumNow ( View Tweet)

Genetic study of 57 systemic JIA children finds presence of MEFV variant p.M694V/I was a risk factor for sJIA (OR: 7.13) https://t.co/TL6WisMQo8 Other studies have shown ~31% of Still's patients at lease 1 genetic variant for periodic fever syndromes. https://t.co/8ppovEw2kt

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Dr. John Cush RheumNow ( View Tweet)

Metformin reduces RA risk in Women - Population study of 2.3 million, found 113749 starting metformin (1998-2014); 558 developed new RA. Adherence (PDC 40–59%) predicted lower adjusted hazard ratio = 0.62, moreso in women on 2550+ qd https://t.co/z6AWWlBpa2

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Dr. John Cush RheumNow ( View Tweet)

Governor Cuomo cites NY study showing front line workers have lower rates of COVID positivity - Suggests that WEARING PPE's Works! (NY population 20% vs 14% transit workers & 12% healthcare workers & 10.5% NYPD and 17% FDNY/EMTs) https://t.co/pfC9rKHKVz

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Dr. John Cush RheumNow ( View Tweet)

Review of Rheumatic Sxs with Immune checkpoint inhibitors - Common are inflammatory arthritis, PMR & myositis. Non-MSK Sxs include sicca, vasculitides and sarcoidosis. SLE and scleroderma are extremely rare. Majority can be Rx w/ steroids. https://t.co/hku5L7hypo

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Dr. John Cush RheumNow ( View Tweet)

NEJM report shows that hospitalizations for acute MI are down ~-40% with the onset of the COVID Crisis (data from Kaiser N. California) - Will the shutdown/lockdown lead to other necessary services or hospital admissions? https://t.co/onpFhsDE9Z

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Dr. John Cush RheumNow ( View Tweet)

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