Jeff Sparks jeffsparks
6 years 4 months ago
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
Dr. John Cush RheumNow
6 years 4 months ago
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
Dr. John Cush RheumNow
6 years 4 months ago
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
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.
Dr. John Cush RheumNow
6 years 4 months ago
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
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.
Dr. John Cush RheumNow
6 years 4 months ago
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
Dr. John Cush RheumNow
6 years 4 months ago
10 FALSE reasons for not wearing a mask - https://t.co/psGrN4iYMs
Please wear a mask out of concern and care for others !!
Dr. John Cush RheumNow
6 years 4 months ago
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
Dr. John Cush RheumNow
6 years 4 months ago
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
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.
Dr. John Cush RheumNow
6 years 4 months ago
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
Dr. John Cush RheumNow
6 years 4 months ago
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
Dr. John Cush RheumNow
6 years 4 months ago
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
