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RheumNow Podcast – The Beat Goes On (5.8.20)

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

  1. Anakinra works in CPPD. Metanalysis of biologics use finds 74 pts Rx with anakinra for refractory dz (85%) or w/ contraindications (23%). Anakinra resp seen in 81% of acute and 43% of chronic CPPD pts. Few adverse events reported (4.1%) https://bit.ly/2z8EB2T 
  2. European Commission has approved Cosentyx (secukinumab) for Rx of adult patients with active non-radiographic axial spondyloarthritis (nr-axSpA) based on results of the Phase III PREVENT trial. (NOT yet FDA/US approved for nr-axSpA) https://t.co/DAWWoG6MJP   
  3. Cigarette Smoking and ANCA-Associated Vasculitis    
  4. Case report of a stable GPA patient treated with pred and Rituxan on 3/5, developed COVID Sxs next day, progressed to high fever, resp failue, mech ventilaion, Rx with antivirals, HCQ; extubated day 20, negative PCR x2 and discharged day 29. https://t.co/SSSKRbYK2R 
  5. World Scleroderma Found Recs on COVID 1) SSc w/ Lung dz may be at risk; 2) Cont Rx & avoid SSc lapse in Rx; 3) SSc pts dont need testing unless Sx+; 4) ACE/ARBs BP meds continued; 5) Initiating preventative Rx w/ HCQ is not recommended https://t.co/8BUE6tLLTi 
  6. American Hospital Association (AHA), in a new report, projected a loss of $202.6 billion from COVID-19 expenses and lost revenue for US hospitals and health systems from Mar 1 to Jun 30—about $50 billion in losses each month. https://bit.ly/2YK0iRt   
  7. Poor COVID outcomes related to active IBD, old age & comorbidities, but NOT to IBD treatments. 79 patients with IBD with COVID-19 were studied, 46% w/ pneumonia (46%), 28% hospitalised, 8% died, 6% adm with COVID-19 & a severe IBD flare. https://t.co/RKrsGlcWI5 
  8. J Allergy Clinical immunology – Type I IFN immunoprofiling in COVID-19 pts. French study of 26 critically ill ICU COVID patients Rx/ w/ standard of care (no antiviral, immunotherapies), 14/26 req mech ventilation). Peak in IFN-α2 seen day 8-10 of Sxs, but 19% failed to produced IFN-I with poorer outcomes, longer ICU stays. https://t.co/hW6TZdjKBs   
  9. COVID-19 and Thrombotic Complications  
  10. Hydroxychloroquine and QTc Prolongation  - 90 COVID hospitalized pts treated with HCQ (53 w/ azithromycin); 20% manifest  QT > 500 msec on HCQ, more if on zpak or loop diurectis – close monitoring warranted 
  11. Hydroxychloroquine's World of Confusion - What you Need to Know  
  12. TNR – Grand Rounds I L-6 in Health & Disease, by Dr. Len Calabrese  

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Disclosures
The author has received compensation as an advisor or consultant on this subject