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RheumNow Podcast – Steroids, IVIG & the Vaccine (1.15.2021)

Jan 15, 2021 3:22 pm

Dr. Jack Cush reviews the news and journal reports from the past week on How to handle COVID19 Vaccine issues, IL-6 inhibition in COVID, Comorbidites in RA, IVIG in dermatomyositis, & more...

  1. Real good historic review of RA drug development wherein Dr Paul Emery interviews Dr. Mike Weinblatt - Good Listen from the Cytokine Signaling Forum podcast
  2. Long Term Safety and Efficacy of Tacrolimus in Lupus Nephritis—Takeuchi et al has published their extensive experience with long-term tacrolimus use in lupus nephritis patients showing its real-world safety and efficacy.
  3. 2 yr Early RA cohort (CareRA) study found that RA patients with co-morbidities had over time lower chances of achieving remission (OR = 0.724; 95% CI: 0.604, 0.867) and a higher risk of hospitalization (OR = 3.725; 95% CI: 2.136, 6.494).
  4. Telemedicine study on accuracy of Pt reported swelling predicting inflamm arthritis. 1637 pts w/ 13 wks of Sxs. 76% pts reported swelling, but only found by 41% of Rheums. Pt reporting sensitivity was was 87%, but specificity only 31%; PPV=46%, NPV=77%
  5. National Psoriasis Foundation Task Force updated their COVID-19 guidance statements. Including Guidance 4.6, stating PsA pts who receive a mRNA-COVID vaccine should continue their biologic or oral therapies as they manage their psoriatic disease
  6. After your 2 doses of COVID vaccine, YES you need to continue to wear a mask, cont. hand washing & social distancing - so as to continue to protect yourself and others. While vaccinated you can still become infected and spread infection.
  7. A patient infected with COVID-19- Yes they should get vaccinated ~90days after infection has resolved.Antibody testing is not needed before you are vaccinated. Evidence suggests that reinfection is uncommon in the 90 days after initial infection.
  8. QD Clinic - What to do After COVID Vaccination
  9. Preprint results of the REMAP-CAP trial in the UK shows that IL-6 inhibitors, when given within 24 hrs of ICU entry for COVID-19, lowers mortality rate by 36%. Hosp mortality in 353 TCZ was 28%, 48 sarilumab was 22% in 402 controls was 36%.
  10. Adipose Transplants as a New Regulator of Osteoarthritis
  11. Corticosteroid Use Hikes CV Risks in Rheumatic Patients
  12. ProDERM Study: IVIG in Dermatomyositis
  13. 2020 Rheumatology Year in Review
The author has received compensation as an advisor or consultant on this subject

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