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RheumNow Podcast – Lupus Delights (9.18.20)

Sep 18, 2020 12:56 am

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

  1. Doximity's 2020 State of Telemedicine report shows the top 10 specialties using telemedicine: 1. Endocrinology; 2. Rheumatology; 3. Gastroenterology, followed by Nephrology Cardiology GU Neurology Geriatrics Heme/onc Pulmonology
  2. Danish matched (1:4) cohort study shows COVID-19 pts taking NSAIDs had no greater risk of mortality, hospitalization, ICU admission, mechanical ventilation, or renal replacement therapy; study included 9,236 COVID PCR-positive & 2.7% were on NSAIDs
  3. Baricitinib in combo with Remdesivir reduces time to recovery in COVID-19 hospitalized pts in NIH-run ACTT-2 Trial w/ >1000 pts randomized to recv 4-mg baricitinib plus remdesivir versus remdesivir alone. Other baricitinib-COVID trials are in progress
  4. Proof-of-concept study colchicine use in the context of COVID-19 infection leads to better survival. 140 consecutive COVID inpatients were Rx w/ standard of care +/- Colchicine. Survival rate @21d was better w/ colchicine (84% vs 64%;p=0.001).
  5. COVID-19 Risks in Pregnant Women
  6. Retrospective cohort study of 213 IMID patients, 36.2% tested positive for COVID-19, who had no greater risk of hospitalized or ventilation and immunosuppressive use was not shown to worsened the course of disease (TNFi decreased risk of hospitalization)
  7. COPDGene study of 361 DISH pts shows DISH carrieds a higher risk of coronary artery disease (OR 1.37 [1.05-1.78] (p=0.019), as measured by coronary calcium scores: 8.8% had CAC = 0; 12.8% CAC1-100; 20.0% CAC100-400 and 24.7% had a CAC>400.
  8. Uncontrolled retrospective observational study of 31 RA-ILD DMARD refractory pts treated with RTX showed RTX to reverse the PFTs decline (∆%pFVC +8.06%; ∆%pDLCO +12.7%) while reducing median prednisone dose at 1 yr. @32 mos, 74% still on RTX.
  9. 4033 Dual-energy CT lesions from 27 pts (23 gout; 4 nonGout) shows definite MSU deposits in MTP1 & patella tendons (high density/volume, low DECT ratio) & non-gout lesions seen in larger jts (knee, midtarsal, talocrural) & tendons (Achilles, quadriceps)
  10. ILD studied in 679 inflammatory idiopathic myositis (IIM) pts; 508 had ILD (found in 93% amyopathic DM, 74% DM & 55% PM). Prevalence of of ILD was higher with antisynthetase Ab + and MDA-5 Ab +. Mortality higher in MDA5+ASA--IM-ILD group (33% vs 12=17%)
  11. Nurses' Health Study (79,568 women) examined the role of diet in 194 incident SLE cases and showed that diets (DASH, Meditteranean, antiinflammatory & healthy diets) had no significant effect of dietary quality on SLE risk
  12. NEJM report of 2 SLE pts treated w/ Daratumumab (anti-CD38) to deplete plasma cells a life-threatening refractory SLE. Clinical improvement associated w/ depletion of plasma cells, reduced IFN type I activity, down-regulation of T-cell transcripts
  13. Taiwan National Health population study of 650 SLE and non-SLE controls undergoing hip replacement. SLE did not incr risk of early prosthetic infx, but did incr risk of late superficial wound infection (11.4% vs. 5.5%, P = 0.01; HR = 2.37)
  14. Updated List of Drugs Inducing Lupus 
  15. Belimumab Effective in Lupus Nephritis
The author has received compensation as an advisor or consultant on this subject

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