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RheumNow Podcast - The SARS-CoV-2 Update (8-14-20)

Aug 14, 2020 10:53 am

Dr. Jack Cush updates the news and joural articles from the past week on

  1. Congrats to the great Dr. Ken Saag, named the new director of the Division of Clinical Immunology & Rheumatology at the University of Alabama at Birmingham. He is the Jane Knight Lowe Professor of medicine and VC of Outcomes & Effectiveness Research UAB
  2. Rheum has 4 of top 10 Best Selling Blockbuster drugs of 2019: 1. Humira $21.4 billion 3. Enbrel $8.1 billion 4. Stelara $6.6 billion 10. Remicade $4.7 billion
  3. 477 Ax-SpA pts in the CORRONA Registry finds 25% with enthesitis - those with enthesitis had worse disease activity and quality of life than those with no enthesitis.
  4. Secukinumab Effective in Non-Radiographic Axial SpA
  5. Apremilast FDA approved for Behcets in 2019 based on significant improvement in oral ulcer severity. What about genital ulcers? There was a signif improvement in QOL, but a nonsignificant trend to genital ulcer resolution (71% vs 41%) in 17 pts.
  6. Correlation study of MRI and OA features finds meniscal extrusion, full thickness cartilage loss and osteophytes were associated with clinical knee pain. Study of 294 OA knee patients from the Osteoarthritis Initiative (at least 4 MRI over 6 years)
  7. BMS has announced deucravacitinib: the generic name for its Tyk2 inhibitor (BMS-986165) - 15 long makes it a new rheum labeling record. It's being studied in Psoriatic arthritis, psoriasis, lupus and inflammatory bowel disease.
  8. Ann Int Med reports that the use of ACE inhbitors or ARB use is not associated with more severe COVID-19 disease (High-certainty evidence), and these meds are not associated w/ pos. SARS-CoV-2 tests- based on observational studies w/ 23565 COVID-19 adults
  9. COVID Testing study of 3046 NY Hospital employees (56% Ab testing, 20% RT-PCR, 12% both); found (9.8%) who tested positive for antibodies; Thus SARS-CoV-2 infection among Hospital workers is lower than that reported for the general public. PPE WORKS!
  10. Prevalence of SARS-CoV-2 Antibodies in Health Care Personnel in NYC - 46 117 were tested. Overall 13.7% were seropositive. For PCR-positive HCP, 93.5% were also seropositive; PCR-negative HCP 89.7% were also seronegative.
  11. Latest COVID-19 Numbers from CDC.  TOTAL CASES  5,119,711; TOTAL DEATHS 163,651   (1,244 New Deaths since yesterday); top 5 states: New York  32,487, New Jersey 15,890, California 10,468, Massachusetts 8751, Texas 8710. Healthcare Personnel and COVID-19:  Cases 130,829   Deaths  618
  12. Rheumatic Diseases, Drugs and COVID-19 Guidelines
    • Determinants of COVID-19 disease severity in patients with underlying rheumatic disease - a Spanish study of 3711 (10%) w/ RDD Inflamm LABS and possibly RDD activity was associated with COVID severity and mortality, but DMARD and biologic use did not associate with poorer outcomes. 
    • COVID‐19 in Patients with Inflammatory Arthritis: A Prospective Study on the Effects of Comorbidities and DMARDs on Clinical Outcomes - A&R report of 103 inflammatory symptomatic COVID‐19 infection; 26 hospitalized and 4 died. glucocorticoids had a higher likelihood COVID‐19 admissin (P <0.001) but anti‐cytokine biologic therapies did not.
    • Risk factors for hospital admissions related to COVID-19 in patients with autoimmune inflammatory rheumatic diseases (AIRD) - an observational study of 123 patients with AIRD and COVID-19; 54  (44%) patients required hospital admission and 12 patients died (22%). Whereas older age (OR: 1.08; p=0.00) and AIRD (OR: 3.55; p=0.01) were risk factors for hospitalization, use of DMARDs were not.
    • SARS CoV-2 infection among patients using immunomodulatory therapies – 38 ID screened over 2500 COVID-19 cases, 77 (3%) were taking immunomodulatory drugs. Overall, 82% were hospitalized and 12% died. There were no deaths among the cohort taking TNF inhibitors or JAK inhibitors.
The author has received compensation as an advisor or consultant on this subject

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