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RheumNow Podcast – In Times of Trouble (4.24.20)

Apr 24, 2020 3:06 pm

Dr Jack Cush reviews the news, journal reports, twitter feed and COVID developments from the past week on

  1. Stay in your seat come times of trouble. Its only people who jump off the roller coaster who get hurt.  - Paul Harvey 
  2. Lower Risk of Diabetes with Abatacept    70k RA claims hazard ratio of ADA 2.0 and infliximab 2.34 
  3. An immunogenicity study w/ live ZOSTAVAX given ~2-wks before tofacitinib showed after mean 27 mos - 5 of 100 TOFA rx pts developed H. Zoster (at 218, 280, 748, 741, 544 days post-vaccination). OOOPs; not very protective. Use Shingrix!   
  4. The greatest risk of treatment-related damage and fatal infections when treating GPA is in the first 3 mos when higher doses of corticosteroids. A study of elderly Rx w/ RTX or CYC for GPA/MPA resulted in less organ damage and hospitalizations. 
  5. Riociguat a guanylate cyclase stimulator w/ antiprolif & anti-inflamm effects studied in a DBRPCT in diffuse Systemic sclerosis; There was more improvement in mRSS (-2.09 vs -0.77), Raynauds (41% vs 26%) & FVC (2.7 vs 7.6) - but these were not significant   
  6. The Current US Death Rate is 50,373 (4/24/20) . Scary as hell ! The COVID-19 death rate in the USA doubles at least every 3 days..... 
  7. MGMA survey of practices finds that 48% of practices have experienced furloughs and 22% layoffs. There has been a 55% decrease in revenue and a 60% decrease in patient volume since the beginning of the pandemic   
  8. NY State study shows 13.9% of population to be COVID (+) by Antibody testing; (+) means previously exposed. (+) COVID results were not different between all age groups. Given 15,500 deaths in NY, that means the COVID death rate is 0.5%   
  9. WHO scientific brief on NSAID use with COVID-19 - notes no direct evidence of harm in COVID-19, SARS, or MERS is available. Indirectly studies show no evidence of severe AE, health utilization, survival, or QOL with COVID-19 owing to NSAID   
  10. VA retrospective study shows worse COVID outcomes w/ HCQ. 368 COVID+ males, Rx w/ 97 HCQ, 113 HCQ + azithromycin, 158 noHCQ. Death Rates: HCQ 27.8%, Combo 22.1%; 11.4% control. Ventilator use not different. 
  11. NYU & Montreal Heart Instit. teaming on the COLCORONA study of Colchicine in early phase COVID-19 infx. TBD in 6,000 patients with mild forms of the disease. Dr. M Pillinger says colchicine, early on, may inhibit damaging inflammatory responses 
  12. GI experts COVID guidelines, state “Despite the potential for increased exposure to SARS-CoV-2, the limited available data and expert opinion suggest that patients with IBD do not appear to have a baseline increased risk of COVID-19infection"   
  13. A Role for Netosis in COVID-19 Infection?     
  14. NIH Consensus Guidelines for the Treatment of COVID-19  
  15. Potential Role of B Cells in COVID    
  16. Dr. Kavanaugh said it well in his blog on the "Upside of Covid" Humanity is really shining thru these days. Im truly touched by all my patients who ask about my health and my safety during COVID-19 == we all have to look out for each other!   
  17. Perhaps love is like a resting place, a shelter from the storm. It exists to give you comfort, it is there to keep you warm, and in those times of trouble when you are most alone, the memory of love will bring you home.  -John Denver
  18. TNR Grand Rounds - Moving Forward with Telemedicine  
  19. How Has COVID-19 Affected You?    


The author has no conflicts of interest to disclose related to this subject

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