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RheumNow Podcast – High Science and Future Treatments (9.10.2021)

Sep 10, 2021 12:02 pm

Dr. Jack Cush reviews the news and journal articles from the past week on

  1. Differential Dx of immune-mediated necrotizing myopathies (IMNM) - HMGCR & Signal recognition particle Abs; checkpoint inhibitors, anti-Mi2 dermatomyositis, antisynthetase syndr. antimitochondrial Abs, GVHD, SARS-CoV-2 infection

  2. MMP13 is one of several key contributors to #OA. Novel research showing the IA depot of nanoparticles w/ small interfering RNAs targeting MMP13 (breaks down type II collagen) can reduce cartilage damage/loss in mouse model of post-traumatic OA

  3. NOVEL: CRISPR-Cas9 genome editing of stem cells allows sensing of local inflammation & proportionally secrete a programmed anti-inflammatory biologic drug. Stem cells implanted in cartilage can prevent pain and inflammatory damage

  4. UK study shows PreClin RA, Establ #RA 1) have increased bowel permeability; 2) gut permeability worsens w/ activity; 3) gut-permeability markers not affected by treatment; 4) in a RA Mouse model-blocking gut permeability ameliorates arthritis

  5. J Hopkins study of 524 myositis-specific Ab positive pts shows that while 91% met 2017 EULAR/ACR criteria for Dx of myositis, 20% of HMGCR+ & 50% anti-PL7 did not classify as myositis; ~10% anti-SRP & HMGCR were dx as inclusion body myositis

  6. Two cohorts from the Nurses’ Health Study (1984–2014 & 1991–2013) showed no association between diet & increased risk of incident #SLE; but that a high nut/legume diet may be associated with a reduced SLE risk

  7. Analysis of records from the Mass General Brigham healthcare system in the Boston area, shows that breakthrough infections (after receiving SARS-CoV-2 vaccines) in patients with SARDs are not uncommon, and may be severe or fatal.

  8. JAMA: In women with spontaneous abortions, COVID-19 vaccine exposure was not increased compared with women without Spont Ab (ongoing pregnancy). COVID-19 vax given to 8.0% ongoing pregnancy vs 8.6% spont ab (adj OR 1.02)

  9. A Mayo Clinic/ Olmsted County study of psoriatic arthritis (PsA) patients has shown that more than half (55%) of PsA patients had a diagnostic delay of > 2 years, and that this delay has not improved over time. #RheumNow

  10. FDA has issued 510(k) (medical device) clearance for the marketing of an artificial intelligence algorithm from Radiobotics to diagnose #OA knee - "RBknee™" can identify osteophytes, subchondral sclerosis, joint space narrowing & width

  11. Dr. Cush is joined by rheumatology colleagues to discuss impressions and impact of the 9/1/21 FDA Drug Safety Communication to physicians regarding new label changes. #RheumNow

  12. Strept pneumoniae vaccinations are underutilized. A Univ of Pittsburgh project utilized EMR reminders to prompt vax w/ Prevnar/PCV13 & Pneumovax/PPSV23. PPSV23 vax increased 28% to 62% and either PPSV23, PCV13 incr 50% to 77% using EMR

  13. MMWR: COVID-19–hospitalization rates in kids & adolescents rose 5-fold late June–mid-Aug 2021 (w/ rise of Delta variant). Hospitalization rates were 10 times higher among unvaccinated than fully vaccinated adolescents.

  14. 3 of 4 COVID hospitalized in NJ are unvaccinated. - 5.6 mill fully Vax; 2.7 mill unvaccinated, - COVID hosp. rate of 4.33/100,000 fully vaccinated & 26.33/100,000 for unvaccinated. - Unvaccinated are nearly 6 times more likely to be COVID hospitalized 

  15. Telephone survey of 278 Rheumatic Pts during COVID (July 2020) showed 22% reduced/interrupted treatments, only 11 (4%) stopped. Decisions made by half (49%). Stop Reasons: anxiety (48%), IV Rx access (45%), Rx unavailability (6.5%)

  16. COVID Breakthrough Infections in Rheumatic Patients 

  17. Back Talk - Complicated Gout

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

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