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RheumNow Podcast – Stop These COVID Mistakes (12.11.20)

Dec 11, 2020 3:48 pm

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

  1. Taiwanese claims data on new RA (2003‐2016) shows decreasing incidence over time. After RA Dx the life expectancy was 26.3 yrs; lifetime cost US$ 72,953. On avg RA pts live 4.97 years less (historically this was 8-11yrs); has biologic era improved this?
  2. 1st refractory to DMARD can be bad omen. RA Study showed 41/402 (10%) were multi-DMARD refractory (MR) and 18% achieved remission/LDAS. DMARD MR predicted by erosions, younger age, high baseline DAS28, delta-DAS < 1.2 1st 6 mos (OR 11.12)
  3. The EMA's CHMP has recommended upadacitinib (Rinvoq) as an indication for the treatment of adults with active Psoriatic Arthritis and Ankylosing Spondylitis.
  4. Phase II/III, double-blind, RCT shown fasinumab (nerve growth factor inhibitor) at higher doses (9mg q4 or q8wks), but not lower doses, improved chronic low back pain w/ best responses at wk 16.. Rapid OA progression seen more w/ FAS (3.8%) vs PBO (0.7%)
  5. Systemic Steroids Seldom Flare Psoriasis
  6. Upadacitinib Effective in Biologic Refractory Psoriatic Arthritis
  7. ACIP Recommendations for Pfizer Vaccine Candidate
  8. Stop Making these mistakes because of COVID-19 Concerns:
    1. Keep your medical appointments - Drs offices have changed to keep you SAFE
    2. Get scheduled blood tests - LabCorp, Quest labs are very safe to go to
    3. Restart usual scheduled visits,eye exams, bone density, annual PCP
The author has received compensation as an advisor or consultant on this subject

Rheumatologists’ Comments

Jitendra Vasandani

| Dec 12, 2020 11:59 am

Hi Jack
I love your RheumNow.
Can you please help me to advise my patients on what to do with their DMARDs / biologics as they get vaccinated? I know to tell them to hold MTX for 2 weeks post flu vaccine but what about other vaccines and what about holding other DMARDs or biologics and for how long?
Patients are also inquiring about Covid vaccine. Do we advise them the same way or differently?
I appreciate you wisdom and advise as always.
Jitendra Vasandani
Lubbock, TX

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