RheumNow Podcast – Gout Guidelines (7.3.20) Save

Dr Jack Cush reviews the journal reports and news from RheumNow this past week. Highlights include:

1. If you treat #SLE patients, Do you get a renal biopsy before starting therapy for Lupus nephritis?   [Twitter Poll]
2. Claims data study of nearly 3 million receiving influenza vaccination shows an increased risk of subsequent subdeltoid bursitis, but incredibly low with an attributable risk was 7.78 additional bursitis per 1 million vaccinated. https://t.co/qtzd8pWk4O
3. Pneumonia vaccination of 21461 RA pts in UK Clinical Practice Research Datalink (2000-18) finds 38.2% vaccinated; 44.3% ≥65 years, 66.4% female; 36.5% vaccinated prior to starting csDMARDs, moreso in elderly. VAX increased over time (esp 2003 to 2007) https://t.co/QTedUMWvE0
4. A federal appeals court on Wednesday upheld two patents for Enbrel (Amgen), rejecting Novartis AG’s effort to void the patents and clear the way for their etanercept biosimilar Erelzi  https://t.co/FsSpbM1O2j
5. National Inpatient study of 61,615 systemic sclerosis pts (1998–2016) finds most common serious infections were pneumonia 45%, sepsis 32%, SSTI 19%; by 2015–2016, sepsis 1.8X more common than pneumonia. Hosp STAYS AND SIE mortality decr over time (10% to 8%)  https://t.co/nv1KjaL3w4
6. A Genetic Probability tool used to calculate risk of rheum Dz in 3 pt cohorts (1211 eMERGE, 245 Partners & 243 early inflam arthritis. Dx AUc: 0.69, 0.81 & 0.84. Likely dx made in 64% & r/o in 45%. ?Could be used to improve Dx accuracy in clinical practice? https://t.co/JiRIxtx3j5
7. Rituximab (RTX)-associated autoimmune disease flare is rare and only seen in 7/185 pts (3.4%); all w/ type II mixed cryoglobulinemia vasculitis. Flare occurred a median 8 days post RTX, as acute kidney insuf, purpura with myocarditis or GI involvement  https://t.co/pgvyddFnAd
8. Schulz-Koops reports 2 #RA patients Rx with RTX who died from COVID pneumonia and ARDS. Both were older, had comorbidities (COPD, HTN, OP) and had received last RTX either 2 wks and 6 mos before COVID infection onset; both had nl IgG levels  https://t.co/j043Tggdbg
9. 66 critically ill & 13 non‐critically ill COVID‐19 were tested for multiple anti‐phospholipid (aPL)Abs. APL common (47%) in critically ill, may be transient (35‐39d post onset). Multiple medium/high levels aPLs may identify at risk for CVA or APS 
10. Series of 11 severe COVID-19 pts Rx w/ Anakinra. 7/11 recv anakinra w/in 36 hrs - none required ventilation. 4 got anakinra after 4days of Resp Sx & required ventilation; 1 died. Pts were SARS‐CoV‐2+, w/ fever, ferritin >1,000 ng/mL & acute resp failure. https://t.co/vegsJPrSGp
11. Tocilizumab May Benefit COVID-19 Pneumonia 
12. COVID's Multisystem Inflammatory Syndrome in Children (MIS-C)
13. Coexistent Gout and Rheumatoid Arthritis 
14. 2020 ACR Gout Management Guideline