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RheumNow Podcast – Don’t Hold the Benlysta, Take the Vaccine (1.22.2021)

Jan 22, 2021 3:04 pm

Dr. Jack Cush reviews the news and journal articles from the past week on, with more than a dozen items to review on this week's podcast.

  1. MMWR reports 10 cases of anaphylaxis after 4 million doses of Moderna COVID-19 vaccine (2.5 cases per million doses administered). 9/10 occurred within 15 minutes of vaccination. No anaphylaxis-related deaths were reported.
  2. Mortality Risk in Rheumatoid Lung Patients A Medicare claims analysis of rheumatoid arthritis (RA) patients showed that RA-associated interstitial lung disease (RA-ILD) was seen in nearly 5% of patients and was found to increase mortality risks. Read on:
  3. Metanalysis RCTs of Antidepressants in painful conditions (LBP, sciatica, hip/knee OA) shows SNRIs (Cymbalta, Savella, Effexor etc) have a small & not clinically important for effect on back pain. A clinically important effect on OA cannot be excluded
  4. Don’t hold Benlysta for the COVID19 vaccine! Previous studies have shown that SLE pts on Benlysta (belimumab) still have good antibody response to vaccinations (including Prevnar14, PPSV23, flu and tetanus vaccines).
  5. Canadian lupus cohort of 560 SLE pts without myositis at baseline. Over time, only 5 pts developed myositis (after mean 8.5 yrs). Incidence = 1.05 per 1000 PYs. Arthritis, Raynauds, -Sm Abs were common, but only non-Whites had increased risk of myositis.
  6. Factors Predictive of SLE Flare After HCQ Taper/Discontinuation The benefits of hydroxychloroquine in lupus are many, but what if you were to withdraw HCQ?
  7. Epidemiologic study of #SLE from CDC & lupus registries estimates there are 204,295 SLE pts in USA (2018). Prevalence=72.8 SLE/100,000 and is 9 X higher in females than males (129 vs 14.6/100,000), especially among Ame Indians/Alaska Natives, Black females
  8. Swedish Armed Forces study suggests the least fit are at greatest risk for developing psoriasis later inlife. From 1968 -2005 1,886,542 military recruits were followed mean 31 yrs. Low CV fitness showed higher rate of psoriasis (HR 1.35) and PsA (HR 1.44)
  9. Results from Cohort Hip & Cohort Knee study (early symptomatic hip OA pts) finds that 1/9 went on to receive hip replacement during the 10-year follow-up. Clinical hip and Xray (ROA) OA increased over 10 yrs - ROA 19% to 49%, and clinical hip OA 27% to 43%
  10. Dr Stanley Cohen has written a nice review of VTE with JAK inhibitors, points out that little/no risk during developmental trials, is not the same as a low risk seen with long term use in real world patients (older, higher BMI, more activity)
  11. Dr. Janet Woodcock has been appointed the interim head of the FDA. President Biden has yet to nominate a new FDA commissioner. Dr. Woodcock is a rheumatologist and current Director of CDER at the FDA .
  12. Travel During COVID-19 Pandemic--The CDC has addressed the effects and the issues of domestic and international travel on its website. Read the full article for more information.
  13. Register for RheumNow Live - March 20,21, 2021; CME 12 hrs
The author has received compensation as an advisor or consultant on this subject

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