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RheumNow Podcast – COVID-19 Responds to Steroids (7.24.20)

Jul 24, 2020 11:10 am

Dr. Jack Cush reviews the News and Journal Reports from the past week on

  1. Cross-sectional survey of 3200 PsA/Pso patients. 65% had both joint & skin involvement. Latter pts had worse QoL, work impairment, higher TJC (5.2) & SJC (4.8) (vs 2.0 & 1.5); more flares (35 vs. 23%, p < 0.001). Jts bigger burden (62%) vs skin (38%)
  2. FDA has issued draft guidance on Cannibis research: “Cannabis & Cannabis-Derived Compounds: Quality Considerations for Clinical Research, Draft Guidance for Industry,” outlines FDA’s current thinking on clinical research related cannabis-derived compounds
  3. Aurinia Announces U.S. Food and Drug Administration Acceptance of the Filing of New Drug Application and Priority Review for Voclosporin for the Treatment of Lupus Nephritis
  4. Systematic review of 100 pts with statin-associated myopathy showed mean age 65 yrs, presenting w/ symmetric prox. muscle weakness, mean CK=6853 IU/l, all were HMG-CoA reductase Ab+ & >80% had necrotizing myopathy & required immunosuppressants
  5. Literature review suggests that TNF inhibitors are safe to use in NAFLD and may show a beneficial effect on hepatic tissue. BUT… TNFi should be prescribed with caution in patients w/ cirrhosis as the data are conflicting.
  6. Retrospective cohort of 147 Adult-Onset Stills Dz pts finds 18 (12.3%) with lung dz (LD) at the diagnosis of AOSD. AOSD-LD were older, w/ more myalgia, LN, pleuritis, ab,dominal pain, more systemic Dz, higher ferritin and more mortality (%39 vs 10%).
  7. CORRONA: 477 axSpA pts showed 25% having enthesitis (3.9 sites) at enrollment. Enthesitis pts were more likely to be female w/ nonradiographic axSpA, more likely to be Rx w/ biologic or DMARD; & Overall - had more disease activity (TJC, SJC, ASAS,BASDAI)
  8. One-third of hospitalized COVID-19 patients have evidence of pulmonary embolism by CT scan. Retrospective study 1477 hospitalized COVID-19 pts; diagnostic yield of Chest CT for PE was 37%, w/ higher Ddimer in PE pts.
  9. 45 yr adult male w/ Kawasaki-like multisystem inflammatory syndrome w/ COVID-19 infx: presented w/ 6d fever, sore throat, diarrhea, LN, BLE pain, conjunctivitis, tachycardia, ESR 120, CRP 546 mg/L, high Troponin; Rx and resolved w/ IVIG & TCZ
  10. Single center retrospective Korean study of 1280 Ankylosing Spondylitis patients (595 exposed to TNFi) showed that TNFi was associated with significantly decreased Xray change rate (mSASSS) (β=−0.112, p=0.004).
  11. Genotyping and microbiota data TwinsUK study (excluding RA) shows that Prevotella spp were positively assoc with RA risk; further validated by first-degree relatives of RA patients where Prevotella was assoc w/ HLA-DRB1 & preclinical arthritis.
  12. Risankizumab Outduels Secukinumab in Psoriasis 
  13. RECOVERY Trial: Dexamethasone in COVID-19
  14. Steroids and Tocilizumab in Cytokine Storm Syndrome
The author has received compensation as an advisor or consultant on this subject

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