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What Worries You, Masters You (7.1.2022)

Jul 01, 2022

Dr. Jack Cush reviews recent news, regulatory and guideline updates from the past week on RheumNow.com.  Studies on methotrexate use, COVID vaccination, Supplements and vitamins, and arthrocentesis despite anticoagulation are discussed.




  1. FDA approved Abbvies risakizumab-rzaa

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Two Week Methotrexate Hold with COVID-19 Vaccination

Jun 24, 2022

A cohort study of rheumatoid arthritis (RA) patients evaluated immunogenicity of COVID vaccination with and without holding methotrexate (MTX) for and 2-weeks and showed better immunogenicity, but more RA flares with the second MTX withdrawal. 

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COVID-19 Death is Dependent on Age and Type I IFN Autoantibodies https://t.co/WrWujgHoA4 https://t.co/NTwUeXHYKr
Dr. John Cush @RheumNow( View Tweet )
Jun 23, 2022
COVID Test Antibody

COVID-19 Death is Dependent on Age and Type I IFN Autoantibodies

Jun 22, 2022

A study in PNAS of has shown that autoantibodies against type I interferons (IFNs) are strong predictors of death from COVID-19. This adds to the evidence that evidence preexisting autoantibodies neutralizing IFNs are strong determinants of life-threatening COVID-19 pneumonia.

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What Happened to Kawasaki Disease During COVID-19?

Jun 20, 2022

During the COVID-19 pandemic, a new COVID-related syndrome in children, the "Multisystem inflammatory syndrome in children" (MIS), was described as being similar to but distinctly different than childhood Kawasaki's disease (KD). A new epidemiologic report shows that while MIS-C cases rose, KD

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COVID-19 hospitalization among Medicare diabled was ~50% higher (3,148/100k) than age matched pop. , and hospitalization rates increased with age in both groups. Among the disabled, American Indian or Alaska Natives had highest rate https://t.co/Xa4NlalHdf https://t.co/dP0c3ajQAW
Dr. John Cush @RheumNow( View Tweet )
Jun 17, 2022
covid coronavirus virus

Spondyloarthritis and COVID-19

Jun 15, 2022

There are still questions surrounding COVID-19, and some common questions I receive from patients revolve around what to do with their current DMARDs or should they even start treatment during this pandemic. Two studies focused on this question. 

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Review on reactive arthritis & COVID: 22 articles , 25 pts (14M:11F), age 45 yrs. Oligoarthritis was most common. Onset (COVID to arthritis) was 6-48 days. Steroids in 13, 2 w/ SSZ, Sxs improved 22/25, mean resolution was 16 +/- 57 days https://t.co/0YABcjz9Gk https://t.co/W5Vnn1NjkD
Dr. John Cush @RheumNow( View Tweet )
Jun 09, 2022
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The Safety of Rituximab and JAK Inhibitors with post-COVID Vaccination

At the onset of the pandemic, data from the Global Rheumatology Alliance reported increased risk of poor severe COVID outcomes including deaths in patients who were treated with rituximab and baricitinib. With the vaccination program undertaken globally, has this risk been attenuated?

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Spondyloarthritis and COVID-19 With the availability of vaccines and new therapeutics, many of our patients are fully vaccinated. We know this can limit their chances of severe COVID all while allowing their rheumatic disease to be treated. #EULAR2022 https://t.co/PmQNKYg1Ao https://t.co/N4DJVYJqrL
Dr. John Cush @RheumNow( View Tweet )
Jun 05, 2022
Biosimilars and COVID vaccines have made nocebo more pertinent than ever. How do we combat it? First line is good communication, and the foot soldiers are the right phrases. Language matters. #EULAR2022 @RheumNow https://t.co/U0Chv9ia1G
Jun 04, 2022
Rituximab/belimumab patients & COVID vaccination response: may have had average antibody response but there’s still the cellular response to consider too! Not as bad. Still caution++, but when ritux really needed we’ll find a way despite COVID from roundup #EULAR2022 @RheumNow https://t.co/zFr6QI9TOG
Jun 04, 2022
Sreekanth et al. 2 studies re holding MTX after both doses vs only 2nd dose of AZ COVID vaccine. Either holding strategy increased ab titres. Only holding 2nd non-inferior to holding both with decreased flares @RheumNow #EULAR2022 LB0003 https://t.co/aCOEdXp4ol https://t.co/XAZyBojryK
Richard Conway @RichardPAConway( View Tweet )
Jun 04, 2022
#EULAR2022 LB0006 SAPHYR: P3 trial, 52 wk: Sarilumab in relapsing PMR Study terminated early due to COVID recruitment ⭐️Sustained remission: 28 vs 10%, primary endpt ⭐️HR of flare 0.56 on Sarilumab ⭐️Less steroid usage, glucocorticoid tox score @Rheumnow https://t.co/5PP1YP7YtU
Jun 04, 2022
#LB0006 #EULAR2022 Therapy for relapsing polymyalgia rheumatica. 118/280 recruited re:COVID impact. Phase 3 RCT of Sarilumab+14Wk Steroid taper showed more pts had sustained remission at Wk52 vs PBO+52Wk Steroid Taper(28% vs 10%) even if CRP excluded. PRO improved too! @RheumNow https://t.co/P11iXIAfGn
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
Jun 04, 2022
#EULAR2022 LB003: W/d MTX w COVID vax MIVAC 1: hold MTX both vax vs continuing MIVAC 2: hold after 2nd dose only vs continuing ⭐️MTX hold: improved Ab titers, no diff in MIVAC1/2 ⭐️Higher reported flare for holding with both doses (36%) vs just 2nd dose (12%) @Rheumnow
Jun 04, 2022
#POS1236 #EULAR2022 More data to justify safety of #COVID vaccination to our #lupus patients. A study in Italy (>450 pts) found 1/4 had side effects (mostly mild) and 4% had a flare. These side effects were more common in those on >1 DMARDS and Belimumab @RheumNow https://t.co/mNS6rQfsSq
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
Jun 04, 2022
Please see my short video on Promising Safety Outlook for Rituximab and Baricitinib in Vaccinated Patients #EULAR2022 @RheumNow https://t.co/bqzdWIzoOg

Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )

Jun 03, 2022
#COVID19 #pandemic has affected #rheumatology training Negative impact on ▶️Learning ▶️Research ▶️Mental health ▶️Physical health 👉🏽https://t.co/Irtkg8TjZtBy @kristenyoung @SuAnnYeoh1 @EBRheum @SattuiSEMD @RichardPAConway @SituationRheum @KilianMD @rheum_covid et al @RheumJnl https://t.co/wysWzE92Fm
Dr Ai Lyn Tan @DrAiLynTan( View Tweet )
Jun 03, 2022
Yusof et al @Yuz6Yusof COVID-19 in RTX treated patients. Significant efficacy of vaccination in both overall and severe COVID rates. Vaccination decreased risk HR 0.13 (0.03-0.51). Number comorbidities and low IgG increase risk @RheumNow #EULAR2022 OP0250 https://t.co/yD1tvs1UYt https://t.co/23XTtPb8fD
Richard Conway @RichardPAConway( View Tweet )
Jun 03, 2022
Roberto Giacomeilli from Italy explaining the mechanisms on how COVID-19 may cause rheumatic disease #EULAR2022 @RheumNow https://t.co/a2kTT7vcRx
Dr. Antoni Chan @synovialjoints( View Tweet )
Jun 03, 2022
COVID-19 mostly mild for majority of SpA patients. Steroid use associated with more severe COVID-19 outcomes (OR 3.15). TNFi found to be protective! (OR 0.26) @RheumNow #EULAR2022 ABST#OP0254

Robert B Chao, MD @doctorRBC( View Tweet )

Jun 03, 2022
#EULAR2022 POS0196 found 9% of post-COVID19 patients developed MSK symptoms. @RheumNow https://t.co/YFT83TjXFL
Dr. Rachel Tate @uptoTate( View Tweet )
Jun 03, 2022
Dr Yeoh @SuAnnYeoh1 @rheum_covid Factors assoc severe COVID outcomes in IIM. Age, male, high disease activity, 2+ comorbidities, pred>7.5mg, RTX, assoc hospitalisation or death @RheumNow #EULAR2022 OP0252 https://t.co/PvCeSX8UvF https://t.co/RaISpeUNsH
Richard Conway @RichardPAConway( View Tweet )
Jun 03, 2022
#EULAR2022 POS0199 showed marked decrease in SARS-CoV2 IgG ab 6 months after initial two dose vaccines. @RheumNow https://t.co/lZdWQUqFvf
Dr. Rachel Tate @uptoTate( View Tweet )
Jun 03, 2022
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