MDedge Rheumatology

The Centers for Disease Control and Prevention’s director Rochelle Walensky, MD, signed off on an advisory panel’s recommendation May 12 endorsing the use of the Pfizer-BioNTech COVID-19 vaccine in adolescents aged 12-15 years.

Earlier in the day the CDC’s Advisory Committee on Immunization Practices voted 14-0 in favor of the safety and effectiveness of the vaccine in younger teens.

“CDC now recommends that this vaccine be used among this population, and providers may begin vaccinating them right away,” Dr. Walensky said in an official statement.

The Food and Drug Administration on May 10 issued an emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 vaccine for the prevention of COVID-19 in individuals 12-15 years old. The FDA first cleared the Pfizer-BioNTech vaccine through an EUA in December 2020 for those ages 16 and older. Pfizer this month also initiated steps with the FDA toward a full approval of its vaccine.

Dr. Walenksy urged parents to seriously consider vaccinating their children.

“Understandably, some parents want more information before their children receive a vaccine,” she said. “I encourage parents with questions to talk to your child’s healthcare provider or your family doctor to learn more about the vaccine.”
 

Vaccine “safe and effective”

Separately, the American Academy of Pediatrics issued a statement May 12 in support of vaccinating all children ages 12 and older who are eligible for the federally authorized COVID-19 vaccine.

“As a pediatrician and a parent, I have looked forward to getting my own children and patients vaccinated, and I am thrilled that those ages 12 and older can now be protected,” said AAP President Lee Savio Beers, MD, in a statement. “The data continue to show that this vaccine is safe and effective. I urge all parents to call their pediatrician to learn more about how to get their children and teens vaccinated.”

The expanded clearance for the Pfizer vaccine is seen as a critical step for allowing teens to resume activities on which they missed out during the pandemic.

“We’ve seen the harm done to children’s mental and emotional health as they’ve missed out on so many experiences during the pandemic,” Dr. Beers said. “Vaccinating children will protect them and allow them to fully engage in all of the activities – school, sports, socializing with friends and family – that are so important to their health and development.”

A version of this article first appeared on Medscape.com.

The Centers for Disease Control and Prevention’s director Rochelle Walensky, MD, signed off on an advisory panel’s recommendation May 12 endorsing the use of the Pfizer-BioNTech COVID-19 vaccine in adolescents aged 12-15 years.

Earlier in the day the CDC’s Advisory Committee on Immunization Practices voted 14-0 in favor of the safety and effectiveness of the vaccine in younger teens.

“CDC now recommends that this vaccine be used among this population, and providers may begin vaccinating them right away,” Dr. Walensky said in an official statement.

The Food and Drug Administration on May 10 issued an emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 vaccine for the prevention of COVID-19 in individuals 12-15 years old. The FDA first cleared the Pfizer-BioNTech vaccine through an EUA in December 2020 for those ages 16 and older. Pfizer this month also initiated steps with the FDA toward a full approval of its vaccine.

Dr. Walenksy urged parents to seriously consider vaccinating their children.

“Understandably, some parents want more information before their children receive a vaccine,” she said. “I encourage parents with questions to talk to your child’s healthcare provider or your family doctor to learn more about the vaccine.”
 

Vaccine “safe and effective”

Separately, the American Academy of Pediatrics issued a statement May 12 in support of vaccinating all children ages 12 and older who are eligible for the federally authorized COVID-19 vaccine.

“As a pediatrician and a parent, I have looked forward to getting my own children and patients vaccinated, and I am thrilled that those ages 12 and older can now be protected,” said AAP President Lee Savio Beers, MD, in a statement. “The data continue to show that this vaccine is safe and effective. I urge all parents to call their pediatrician to learn more about how to get their children and teens vaccinated.”

The expanded clearance for the Pfizer vaccine is seen as a critical step for allowing teens to resume activities on which they missed out during the pandemic.

“We’ve seen the harm done to children’s mental and emotional health as they’ve missed out on so many experiences during the pandemic,” Dr. Beers said. “Vaccinating children will protect them and allow them to fully engage in all of the activities – school, sports, socializing with friends and family – that are so important to their health and development.”

A version of this article first appeared on Medscape.com.

The Centers for Disease Control and Prevention’s director Rochelle Walensky, MD, signed off on an advisory panel’s recommendation May 12 endorsing the use of the Pfizer-BioNTech COVID-19 vaccine in adolescents aged 12-15 years.

Earlier in the day the CDC’s Advisory Committee on Immunization Practices voted 14-0 in favor of the safety and effectiveness of the vaccine in younger teens.

“CDC now recommends that this vaccine be used among this population, and providers may begin vaccinating them right away,” Dr. Walensky said in an official statement.

The Food and Drug Administration on May 10 issued an emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 vaccine for the prevention of COVID-19 in individuals 12-15 years old. The FDA first cleared the Pfizer-BioNTech vaccine through an EUA in December 2020 for those ages 16 and older. Pfizer this month also initiated steps with the FDA toward a full approval of its vaccine.

Dr. Walenksy urged parents to seriously consider vaccinating their children.

“Understandably, some parents want more information before their children receive a vaccine,” she said. “I encourage parents with questions to talk to your child’s healthcare provider or your family doctor to learn more about the vaccine.”
 

Vaccine “safe and effective”

Separately, the American Academy of Pediatrics issued a statement May 12 in support of vaccinating all children ages 12 and older who are eligible for the federally authorized COVID-19 vaccine.

“As a pediatrician and a parent, I have looked forward to getting my own children and patients vaccinated, and I am thrilled that those ages 12 and older can now be protected,” said AAP President Lee Savio Beers, MD, in a statement. “The data continue to show that this vaccine is safe and effective. I urge all parents to call their pediatrician to learn more about how to get their children and teens vaccinated.”

The expanded clearance for the Pfizer vaccine is seen as a critical step for allowing teens to resume activities on which they missed out during the pandemic.

“We’ve seen the harm done to children’s mental and emotional health as they’ve missed out on so many experiences during the pandemic,” Dr. Beers said. “Vaccinating children will protect them and allow them to fully engage in all of the activities – school, sports, socializing with friends and family – that are so important to their health and development.”

A version of this article first appeared on Medscape.com.

Rheumatology News and the Coalition of State Rheumatology Organizations have partnered together to keep rheumatologists regularly informed on the advocacy issues of the day and perhaps inspire those who may be on the fence about finding “room” in their lives for action. This inaugural piece tells how CSRO President Dr. Madelaine (Mattie) A. Feldman views advocacy and how she found her way to action.

As a rheumatologist in private practice for 30 years, with husband and kids (and now grandkids), an active social life, and an exercise regimen, I realized if I were to become active in advocacy I would have to make room for it in my busy schedule. We all come up against the question of where will we find the time for a new hobby, exercise, joining a new organization, or even just eating right? Next comes the priority list discussion. How important is advocacy for my patients, my specialty, and my profession? Ultimately, how important is it for me? Where did that desire to get involved even come from? Why have I become so passionate about the issues?

For me, the answer to these questions goes back to the 1960s when I was growing up in New Orleans. My mom participated in civil rights protests, which did not make our family popular in the neighborhood, back when the KKK put flyers on everyone’s screen door. My mother didn’t care and told me that, no matter what people said, it was our duty to stand up for what was right. That was a long time ago and sadly my mom passed away just a year after I was old enough to vote. Her words have stayed with me and are more important now than ever.

Striving for justice despite how formidable the foe is requires an inner knowing that what you are doing is meaningful and will make a difference maybe not now, maybe not next year. At some point you must believe that your efforts will create a change for the better, small as it may be. My “saying” on Twitter (@MattieRheumMD) is “I’ll keep doing what I’m doing until my cynicism catches up to my passion.”

The story about my mom is just one of the many stories in my life taking me to where I am today. We all have them. I think the reason many of us go into rheumatology may be similar to the reasoning that leads one to advocacy efforts. At this point in time we can’t yet offer a cure, but we can point to a path that leads to improvements in the lives of our patients. I have to remind myself of that, every time there is an advocacy battle ahead, whether with insurance companies or the government ... increments are important.
 

The four Ps of advocacy

Living with compromise is hard, particularly when working within a system that needs a complete overhaul. Still, compromise is the key to getting anything done. Compromise is one of the four Ps of advocacy. I realize that compromise doesn’t start with a P, but it is such an integral part of advocacy, I am making allowances for it. The other Ps include patience, persistence/perseverance, and passion. I’m sure there are many others that could be part of the P family, like planning and performance, but let’s stick with these.

You don’t need to have all of these qualities when you start on the road to action in advocacy. For example, my passion came first. It developed when my patients could not get access to the treatments they needed. For many reasons, the medications were either unavailable (i.e., not on formulary, tiered very high) or unaffordable (i.e., copay too high, deductible too high). My passion deepened when I saw the hypocrisy within the drug-supply channel and the mistruths being told by those who profit from this channel. It wasn’t the “profit” part that bothered me, as I’m a believer in the free market. But this was not free market, and the companies were actually profiteering on the backs of my patients and justifying it by claiming they were saving the health care system billions of dollars. The fallacy of that claim and the players in this broken system are stories for another day.

Persistence came next for me. If you let up on the message, things might not only stay the same but could get worse. Perseverance is part of persistence because you need it to keep knocking on the same door even after that door is metaphorically (hopefully not literally) slammed in your face. Often, I will feel like a broken record and think that everyone has already heard the issues, not only from me but also from my fellow advocates. But never underestimate how many times a message, particularly on a difficult issue to understand, needs to be heard before it is fully comprehended.

Patience is one of the more difficult attributes to practice when you want action. I want things to happen yesterday – not tomorrow and definitely not next year. I have learned that the wheels of change turn quite slowly in this arena, sometimes pausing for inordinately long periods of time. I realize now that during the long wait, new facts can arise, allowing me to shape a different advocacy approach, one that ultimately bolsters my case. It still is very difficult to hear that a piece of legislation that seemed to be moving forward suddenly died and won’t be heard again until the next session. With patience you move forward with a smile, maybe a half-hearted one, but a smile nonetheless. This just makes life better.

Then there is compromise. This took me the longest to understand, particularly on the issues where my passion ran the deepest. Here is where passion could potentially get in the way of action. Feeling very strongly about an issue makes it difficult to let any piece of your ideal end result fall by the wayside. Here is where the saying “the perfect is the enemy of the good” comes into play. Just because you can’t have it all, doesn’t mean you can’t do good by achieving just part of what you have been striving for. Remember if you seek perfection, without compromise, you may lose the entire battle. Is there such a thing as compromising too much? I think so, but that may just be my passion speaking.

Rheumatology News and the Coalition of State Rheumatology Organizations started this column to keep you informed about current advocacy issues in rheumatology and perhaps inspire those who may be on the fence about finding “room” in their lives for action.

Advocacy doesn’t have to take up much room in your life. It can be as simple as clicking on CSRO.info/map, finding your state, and taking action by writing a letter to your representative on an important piece of legislation, like an accumulator adjustment ban (lots more on that in future columns). Or maybe just finding the time to read this column is all the action you have room for. We all have different amounts of space for any particular activity in our busy lives. It seems one of my stories from childhood created that space for advocacy in my life. I guess you could say it created a “Rheum” for Action.

Dr. Feldman is a rheumatologist in private practice with The Rheumatology Group in New Orleans. She is President of the CSRO, chair of the Alliance for Safe Biologic Medicines, and a past member of the American College of Rheumatology insurance subcommittee. You can reach her at [email protected].

Rheumatology News and the Coalition of State Rheumatology Organizations have partnered together to keep rheumatologists regularly informed on the advocacy issues of the day and perhaps inspire those who may be on the fence about finding “room” in their lives for action. This inaugural piece tells how CSRO President Dr. Madelaine (Mattie) A. Feldman views advocacy and how she found her way to action.

As a rheumatologist in private practice for 30 years, with husband and kids (and now grandkids), an active social life, and an exercise regimen, I realized if I were to become active in advocacy I would have to make room for it in my busy schedule. We all come up against the question of where will we find the time for a new hobby, exercise, joining a new organization, or even just eating right? Next comes the priority list discussion. How important is advocacy for my patients, my specialty, and my profession? Ultimately, how important is it for me? Where did that desire to get involved even come from? Why have I become so passionate about the issues?

For me, the answer to these questions goes back to the 1960s when I was growing up in New Orleans. My mom participated in civil rights protests, which did not make our family popular in the neighborhood, back when the KKK put flyers on everyone’s screen door. My mother didn’t care and told me that, no matter what people said, it was our duty to stand up for what was right. That was a long time ago and sadly my mom passed away just a year after I was old enough to vote. Her words have stayed with me and are more important now than ever.

Striving for justice despite how formidable the foe is requires an inner knowing that what you are doing is meaningful and will make a difference maybe not now, maybe not next year. At some point you must believe that your efforts will create a change for the better, small as it may be. My “saying” on Twitter (@MattieRheumMD) is “I’ll keep doing what I’m doing until my cynicism catches up to my passion.”

The story about my mom is just one of the many stories in my life taking me to where I am today. We all have them. I think the reason many of us go into rheumatology may be similar to the reasoning that leads one to advocacy efforts. At this point in time we can’t yet offer a cure, but we can point to a path that leads to improvements in the lives of our patients. I have to remind myself of that, every time there is an advocacy battle ahead, whether with insurance companies or the government ... increments are important.
 

The four Ps of advocacy

Living with compromise is hard, particularly when working within a system that needs a complete overhaul. Still, compromise is the key to getting anything done. Compromise is one of the four Ps of advocacy. I realize that compromise doesn’t start with a P, but it is such an integral part of advocacy, I am making allowances for it. The other Ps include patience, persistence/perseverance, and passion. I’m sure there are many others that could be part of the P family, like planning and performance, but let’s stick with these.

You don’t need to have all of these qualities when you start on the road to action in advocacy. For example, my passion came first. It developed when my patients could not get access to the treatments they needed. For many reasons, the medications were either unavailable (i.e., not on formulary, tiered very high) or unaffordable (i.e., copay too high, deductible too high). My passion deepened when I saw the hypocrisy within the drug-supply channel and the mistruths being told by those who profit from this channel. It wasn’t the “profit” part that bothered me, as I’m a believer in the free market. But this was not free market, and the companies were actually profiteering on the backs of my patients and justifying it by claiming they were saving the health care system billions of dollars. The fallacy of that claim and the players in this broken system are stories for another day.

Persistence came next for me. If you let up on the message, things might not only stay the same but could get worse. Perseverance is part of persistence because you need it to keep knocking on the same door even after that door is metaphorically (hopefully not literally) slammed in your face. Often, I will feel like a broken record and think that everyone has already heard the issues, not only from me but also from my fellow advocates. But never underestimate how many times a message, particularly on a difficult issue to understand, needs to be heard before it is fully comprehended.

Patience is one of the more difficult attributes to practice when you want action. I want things to happen yesterday – not tomorrow and definitely not next year. I have learned that the wheels of change turn quite slowly in this arena, sometimes pausing for inordinately long periods of time. I realize now that during the long wait, new facts can arise, allowing me to shape a different advocacy approach, one that ultimately bolsters my case. It still is very difficult to hear that a piece of legislation that seemed to be moving forward suddenly died and won’t be heard again until the next session. With patience you move forward with a smile, maybe a half-hearted one, but a smile nonetheless. This just makes life better.

Then there is compromise. This took me the longest to understand, particularly on the issues where my passion ran the deepest. Here is where passion could potentially get in the way of action. Feeling very strongly about an issue makes it difficult to let any piece of your ideal end result fall by the wayside. Here is where the saying “the perfect is the enemy of the good” comes into play. Just because you can’t have it all, doesn’t mean you can’t do good by achieving just part of what you have been striving for. Remember if you seek perfection, without compromise, you may lose the entire battle. Is there such a thing as compromising too much? I think so, but that may just be my passion speaking.

Rheumatology News and the Coalition of State Rheumatology Organizations started this column to keep you informed about current advocacy issues in rheumatology and perhaps inspire those who may be on the fence about finding “room” in their lives for action.

Advocacy doesn’t have to take up much room in your life. It can be as simple as clicking on CSRO.info/map, finding your state, and taking action by writing a letter to your representative on an important piece of legislation, like an accumulator adjustment ban (lots more on that in future columns). Or maybe just finding the time to read this column is all the action you have room for. We all have different amounts of space for any particular activity in our busy lives. It seems one of my stories from childhood created that space for advocacy in my life. I guess you could say it created a “Rheum” for Action.

Dr. Feldman is a rheumatologist in private practice with The Rheumatology Group in New Orleans. She is President of the CSRO, chair of the Alliance for Safe Biologic Medicines, and a past member of the American College of Rheumatology insurance subcommittee. You can reach her at [email protected].

Rheumatology News and the Coalition of State Rheumatology Organizations have partnered together to keep rheumatologists regularly informed on the advocacy issues of the day and perhaps inspire those who may be on the fence about finding “room” in their lives for action. This inaugural piece tells how CSRO President Dr. Madelaine (Mattie) A. Feldman views advocacy and how she found her way to action.

As a rheumatologist in private practice for 30 years, with husband and kids (and now grandkids), an active social life, and an exercise regimen, I realized if I were to become active in advocacy I would have to make room for it in my busy schedule. We all come up against the question of where will we find the time for a new hobby, exercise, joining a new organization, or even just eating right? Next comes the priority list discussion. How important is advocacy for my patients, my specialty, and my profession? Ultimately, how important is it for me? Where did that desire to get involved even come from? Why have I become so passionate about the issues?

For me, the answer to these questions goes back to the 1960s when I was growing up in New Orleans. My mom participated in civil rights protests, which did not make our family popular in the neighborhood, back when the KKK put flyers on everyone’s screen door. My mother didn’t care and told me that, no matter what people said, it was our duty to stand up for what was right. That was a long time ago and sadly my mom passed away just a year after I was old enough to vote. Her words have stayed with me and are more important now than ever.

Striving for justice despite how formidable the foe is requires an inner knowing that what you are doing is meaningful and will make a difference maybe not now, maybe not next year. At some point you must believe that your efforts will create a change for the better, small as it may be. My “saying” on Twitter (@MattieRheumMD) is “I’ll keep doing what I’m doing until my cynicism catches up to my passion.”

The story about my mom is just one of the many stories in my life taking me to where I am today. We all have them. I think the reason many of us go into rheumatology may be similar to the reasoning that leads one to advocacy efforts. At this point in time we can’t yet offer a cure, but we can point to a path that leads to improvements in the lives of our patients. I have to remind myself of that, every time there is an advocacy battle ahead, whether with insurance companies or the government ... increments are important.
 

The four Ps of advocacy

Living with compromise is hard, particularly when working within a system that needs a complete overhaul. Still, compromise is the key to getting anything done. Compromise is one of the four Ps of advocacy. I realize that compromise doesn’t start with a P, but it is such an integral part of advocacy, I am making allowances for it. The other Ps include patience, persistence/perseverance, and passion. I’m sure there are many others that could be part of the P family, like planning and performance, but let’s stick with these.

You don’t need to have all of these qualities when you start on the road to action in advocacy. For example, my passion came first. It developed when my patients could not get access to the treatments they needed. For many reasons, the medications were either unavailable (i.e., not on formulary, tiered very high) or unaffordable (i.e., copay too high, deductible too high). My passion deepened when I saw the hypocrisy within the drug-supply channel and the mistruths being told by those who profit from this channel. It wasn’t the “profit” part that bothered me, as I’m a believer in the free market. But this was not free market, and the companies were actually profiteering on the backs of my patients and justifying it by claiming they were saving the health care system billions of dollars. The fallacy of that claim and the players in this broken system are stories for another day.

Persistence came next for me. If you let up on the message, things might not only stay the same but could get worse. Perseverance is part of persistence because you need it to keep knocking on the same door even after that door is metaphorically (hopefully not literally) slammed in your face. Often, I will feel like a broken record and think that everyone has already heard the issues, not only from me but also from my fellow advocates. But never underestimate how many times a message, particularly on a difficult issue to understand, needs to be heard before it is fully comprehended.

Patience is one of the more difficult attributes to practice when you want action. I want things to happen yesterday – not tomorrow and definitely not next year. I have learned that the wheels of change turn quite slowly in this arena, sometimes pausing for inordinately long periods of time. I realize now that during the long wait, new facts can arise, allowing me to shape a different advocacy approach, one that ultimately bolsters my case. It still is very difficult to hear that a piece of legislation that seemed to be moving forward suddenly died and won’t be heard again until the next session. With patience you move forward with a smile, maybe a half-hearted one, but a smile nonetheless. This just makes life better.

Then there is compromise. This took me the longest to understand, particularly on the issues where my passion ran the deepest. Here is where passion could potentially get in the way of action. Feeling very strongly about an issue makes it difficult to let any piece of your ideal end result fall by the wayside. Here is where the saying “the perfect is the enemy of the good” comes into play. Just because you can’t have it all, doesn’t mean you can’t do good by achieving just part of what you have been striving for. Remember if you seek perfection, without compromise, you may lose the entire battle. Is there such a thing as compromising too much? I think so, but that may just be my passion speaking.

Rheumatology News and the Coalition of State Rheumatology Organizations started this column to keep you informed about current advocacy issues in rheumatology and perhaps inspire those who may be on the fence about finding “room” in their lives for action.

Advocacy doesn’t have to take up much room in your life. It can be as simple as clicking on CSRO.info/map, finding your state, and taking action by writing a letter to your representative on an important piece of legislation, like an accumulator adjustment ban (lots more on that in future columns). Or maybe just finding the time to read this column is all the action you have room for. We all have different amounts of space for any particular activity in our busy lives. It seems one of my stories from childhood created that space for advocacy in my life. I guess you could say it created a “Rheum” for Action.

Dr. Feldman is a rheumatologist in private practice with The Rheumatology Group in New Orleans. She is President of the CSRO, chair of the Alliance for Safe Biologic Medicines, and a past member of the American College of Rheumatology insurance subcommittee. You can reach her at [email protected].

Six months after mild SARS-CoV-2 infection in a representative health care workforce, no long-term cardiovascular sequelae were detected, compared with a matched SARS-CoV-2 seronegative group.

“Mild COVID-19 left no measurable cardiovascular impact on LV structure, function, scar burden, aortic stiffness, or serum biomarkers,” the researchers reported in an article published online May 8 in JACC: Cardiovascular Imaging.

“We provide societal reassurance and support for the position that screening in asymptomatic individuals following mild disease is not indicated,” first author George Joy, MBBS, University College London, said in presenting the results at EuroCMR, the annual CMR congress of the European Association of Cardiovascular Imaging (EACVI).

Briefing comoderator Leyla Elif Sade, MD, University of Baskent, Ankara, Turkey, said, “This is the hot topic of our time because of obvious reasons and I think [this] study is quite important to avoid unnecessary further testing, surveillance testing, and to avoid a significant burden of health care costs.”
 

‘Alarming’ early data

Early cardiac magnetic resonance (CMR) studies in patients recovered from mild COVID-19 were “alarming,” Dr. Joy said.

As previously reported, one study showed cardiac abnormalities after mild COVID-19 in up to 78% of patients, with evidence of ongoing myocardial inflammation in 60%. The CMR findings correlated with elevations in troponin T by high-sensitivity assay (hs-TnT).

To investigate further, Dr. Joy and colleagues did a nested case-control study within the COVIDsortium, a prospective study of 731 health care workers from three London hospitals who underwent weekly symptom, polymerase chain reaction, and serology assessment over 4 months during the first wave of the pandemic.

A total of 157 (21.5%) participants seroconverted during the study period.

Six months after infection, 74 seropositive (median age, 39; 62% women) and 75 age-, sex-, and ethnicity-matched seronegative controls underwent cardiovascular phenotyping (comprehensive phantom-calibrated CMR and blood biomarkers). The analysis was blinded, using objective artificial intelligence analytics when available.

The results showed no statistically significant differences between seropositive and seronegative participants in cardiac structure (left ventricular volumes, mass, atrial area), function (ejection fraction, global longitudinal shortening, aortic distensibility), tissue characterization (T1, T2, extracellular volume fraction mapping, late gadolinium enhancement) or biomarkers (troponin, N-terminal pro–B-type natriuretic peptide).

Cardiovascular abnormalities were no more common in seropositive than seronegative otherwise healthy health care workers 6 months post mild SARS-CoV-2 infection. Measured abnormalities were “evenly distributed between both groups,” Dr. Joy said.

Therefore, it’s “important to reassure patients with mild SARS-CoV-2 infection regarding its cardiovascular effects,” Dr. Joy and colleagues concluded.
 

Limitations and caveats

They caution, however, that the study provides insight only into the short- to medium-term sequelae of patients aged 18-69 with mild COVID-19 who did not require hospitalization and had low numbers of comorbidities.

The study does not address the cardiovascular effects after severe COVID-19 infection requiring hospitalization or in those with multiple comorbid conditions, they noted. It also does not prove that apparently mild SARS-CoV-2 never causes chronic myocarditis.

“The study design would not distinguish between people who had sustained completely healed myocarditis and pericarditis and those in whom the heart had never been affected,” the researchers noted.

They pointed to a recent cross-sectional study of athletes 1-month post mild COVID-19 that found significant pericardial involvement (late enhancement and/or pericardial effusion), although no baseline pre-COVID-19 imaging was performed. In the current study at 6 months post infection the pericardium was normal.

The coauthors of a linked editorial say this study provides “welcome, reassuring information that in healthy individuals who experience mild infection with COVID-19, persisting evidence of cardiovascular complications is very uncommon. The results do not support cardiovascular screening in individuals with mild or asymptomatic infection with COVID-19.”  

Colin Berry, PhD, and Kenneth Mangion, PhD, both from University of Glasgow, cautioned that the population is restricted to health care workers; therefore, the findings may not necessarily be generalized to a community population .

“Healthcare workers do not reflect the population of individuals most clinically affected by COVID-19 illness. The severity of acute COVID-19 infection is greatest in older individuals and those with preexisting health problems. Healthcare workers are not representative of the wider, unselected, at-risk, community population,” they pointed out.

Cardiovascular risk factors and concomitant health problems (heart and respiratory disease) may be more common in the community than in health care workers, and prior studies have highlighted their potential impact for disease pathogenesis in COVID-19.

Dr. Berry and Dr. Mangion also noted that women made up nearly two-thirds of the seropositive group. This may reflect a selection bias or may naturally reflect the fact that proportionately more women are asymptomatic or have milder forms of illness, whereas severe SARS-CoV-2 infection requiring hospitalization affects men to a greater degree.

COVIDsortium funding was donated by individuals, charitable trusts, and corporations including Goldman Sachs, Citadel and Citadel Securities, The Guy Foundation, GW Pharmaceuticals, Kusuma Trust, and Jagclif Charitable Trust, and enabled by Barts Charity with support from UCLH Charity. The authors have disclosed no relevant financial relationships.

A version of this article first appeared on Medscape.com.

Six months after mild SARS-CoV-2 infection in a representative health care workforce, no long-term cardiovascular sequelae were detected, compared with a matched SARS-CoV-2 seronegative group.

“Mild COVID-19 left no measurable cardiovascular impact on LV structure, function, scar burden, aortic stiffness, or serum biomarkers,” the researchers reported in an article published online May 8 in JACC: Cardiovascular Imaging.

“We provide societal reassurance and support for the position that screening in asymptomatic individuals following mild disease is not indicated,” first author George Joy, MBBS, University College London, said in presenting the results at EuroCMR, the annual CMR congress of the European Association of Cardiovascular Imaging (EACVI).

Briefing comoderator Leyla Elif Sade, MD, University of Baskent, Ankara, Turkey, said, “This is the hot topic of our time because of obvious reasons and I think [this] study is quite important to avoid unnecessary further testing, surveillance testing, and to avoid a significant burden of health care costs.”
 

‘Alarming’ early data

Early cardiac magnetic resonance (CMR) studies in patients recovered from mild COVID-19 were “alarming,” Dr. Joy said.

As previously reported, one study showed cardiac abnormalities after mild COVID-19 in up to 78% of patients, with evidence of ongoing myocardial inflammation in 60%. The CMR findings correlated with elevations in troponin T by high-sensitivity assay (hs-TnT).

To investigate further, Dr. Joy and colleagues did a nested case-control study within the COVIDsortium, a prospective study of 731 health care workers from three London hospitals who underwent weekly symptom, polymerase chain reaction, and serology assessment over 4 months during the first wave of the pandemic.

A total of 157 (21.5%) participants seroconverted during the study period.

Six months after infection, 74 seropositive (median age, 39; 62% women) and 75 age-, sex-, and ethnicity-matched seronegative controls underwent cardiovascular phenotyping (comprehensive phantom-calibrated CMR and blood biomarkers). The analysis was blinded, using objective artificial intelligence analytics when available.

The results showed no statistically significant differences between seropositive and seronegative participants in cardiac structure (left ventricular volumes, mass, atrial area), function (ejection fraction, global longitudinal shortening, aortic distensibility), tissue characterization (T1, T2, extracellular volume fraction mapping, late gadolinium enhancement) or biomarkers (troponin, N-terminal pro–B-type natriuretic peptide).

Cardiovascular abnormalities were no more common in seropositive than seronegative otherwise healthy health care workers 6 months post mild SARS-CoV-2 infection. Measured abnormalities were “evenly distributed between both groups,” Dr. Joy said.

Therefore, it’s “important to reassure patients with mild SARS-CoV-2 infection regarding its cardiovascular effects,” Dr. Joy and colleagues concluded.
 

Limitations and caveats

They caution, however, that the study provides insight only into the short- to medium-term sequelae of patients aged 18-69 with mild COVID-19 who did not require hospitalization and had low numbers of comorbidities.

The study does not address the cardiovascular effects after severe COVID-19 infection requiring hospitalization or in those with multiple comorbid conditions, they noted. It also does not prove that apparently mild SARS-CoV-2 never causes chronic myocarditis.

“The study design would not distinguish between people who had sustained completely healed myocarditis and pericarditis and those in whom the heart had never been affected,” the researchers noted.

They pointed to a recent cross-sectional study of athletes 1-month post mild COVID-19 that found significant pericardial involvement (late enhancement and/or pericardial effusion), although no baseline pre-COVID-19 imaging was performed. In the current study at 6 months post infection the pericardium was normal.

The coauthors of a linked editorial say this study provides “welcome, reassuring information that in healthy individuals who experience mild infection with COVID-19, persisting evidence of cardiovascular complications is very uncommon. The results do not support cardiovascular screening in individuals with mild or asymptomatic infection with COVID-19.”  

Colin Berry, PhD, and Kenneth Mangion, PhD, both from University of Glasgow, cautioned that the population is restricted to health care workers; therefore, the findings may not necessarily be generalized to a community population .

“Healthcare workers do not reflect the population of individuals most clinically affected by COVID-19 illness. The severity of acute COVID-19 infection is greatest in older individuals and those with preexisting health problems. Healthcare workers are not representative of the wider, unselected, at-risk, community population,” they pointed out.

Cardiovascular risk factors and concomitant health problems (heart and respiratory disease) may be more common in the community than in health care workers, and prior studies have highlighted their potential impact for disease pathogenesis in COVID-19.

Dr. Berry and Dr. Mangion also noted that women made up nearly two-thirds of the seropositive group. This may reflect a selection bias or may naturally reflect the fact that proportionately more women are asymptomatic or have milder forms of illness, whereas severe SARS-CoV-2 infection requiring hospitalization affects men to a greater degree.

COVIDsortium funding was donated by individuals, charitable trusts, and corporations including Goldman Sachs, Citadel and Citadel Securities, The Guy Foundation, GW Pharmaceuticals, Kusuma Trust, and Jagclif Charitable Trust, and enabled by Barts Charity with support from UCLH Charity. The authors have disclosed no relevant financial relationships.

A version of this article first appeared on Medscape.com.

Six months after mild SARS-CoV-2 infection in a representative health care workforce, no long-term cardiovascular sequelae were detected, compared with a matched SARS-CoV-2 seronegative group.

“Mild COVID-19 left no measurable cardiovascular impact on LV structure, function, scar burden, aortic stiffness, or serum biomarkers,” the researchers reported in an article published online May 8 in JACC: Cardiovascular Imaging.

“We provide societal reassurance and support for the position that screening in asymptomatic individuals following mild disease is not indicated,” first author George Joy, MBBS, University College London, said in presenting the results at EuroCMR, the annual CMR congress of the European Association of Cardiovascular Imaging (EACVI).

Briefing comoderator Leyla Elif Sade, MD, University of Baskent, Ankara, Turkey, said, “This is the hot topic of our time because of obvious reasons and I think [this] study is quite important to avoid unnecessary further testing, surveillance testing, and to avoid a significant burden of health care costs.”
 

‘Alarming’ early data

Early cardiac magnetic resonance (CMR) studies in patients recovered from mild COVID-19 were “alarming,” Dr. Joy said.

As previously reported, one study showed cardiac abnormalities after mild COVID-19 in up to 78% of patients, with evidence of ongoing myocardial inflammation in 60%. The CMR findings correlated with elevations in troponin T by high-sensitivity assay (hs-TnT).

To investigate further, Dr. Joy and colleagues did a nested case-control study within the COVIDsortium, a prospective study of 731 health care workers from three London hospitals who underwent weekly symptom, polymerase chain reaction, and serology assessment over 4 months during the first wave of the pandemic.

A total of 157 (21.5%) participants seroconverted during the study period.

Six months after infection, 74 seropositive (median age, 39; 62% women) and 75 age-, sex-, and ethnicity-matched seronegative controls underwent cardiovascular phenotyping (comprehensive phantom-calibrated CMR and blood biomarkers). The analysis was blinded, using objective artificial intelligence analytics when available.

The results showed no statistically significant differences between seropositive and seronegative participants in cardiac structure (left ventricular volumes, mass, atrial area), function (ejection fraction, global longitudinal shortening, aortic distensibility), tissue characterization (T1, T2, extracellular volume fraction mapping, late gadolinium enhancement) or biomarkers (troponin, N-terminal pro–B-type natriuretic peptide).

Cardiovascular abnormalities were no more common in seropositive than seronegative otherwise healthy health care workers 6 months post mild SARS-CoV-2 infection. Measured abnormalities were “evenly distributed between both groups,” Dr. Joy said.

Therefore, it’s “important to reassure patients with mild SARS-CoV-2 infection regarding its cardiovascular effects,” Dr. Joy and colleagues concluded.
 

Limitations and caveats

They caution, however, that the study provides insight only into the short- to medium-term sequelae of patients aged 18-69 with mild COVID-19 who did not require hospitalization and had low numbers of comorbidities.

The study does not address the cardiovascular effects after severe COVID-19 infection requiring hospitalization or in those with multiple comorbid conditions, they noted. It also does not prove that apparently mild SARS-CoV-2 never causes chronic myocarditis.

“The study design would not distinguish between people who had sustained completely healed myocarditis and pericarditis and those in whom the heart had never been affected,” the researchers noted.

They pointed to a recent cross-sectional study of athletes 1-month post mild COVID-19 that found significant pericardial involvement (late enhancement and/or pericardial effusion), although no baseline pre-COVID-19 imaging was performed. In the current study at 6 months post infection the pericardium was normal.

The coauthors of a linked editorial say this study provides “welcome, reassuring information that in healthy individuals who experience mild infection with COVID-19, persisting evidence of cardiovascular complications is very uncommon. The results do not support cardiovascular screening in individuals with mild or asymptomatic infection with COVID-19.”  

Colin Berry, PhD, and Kenneth Mangion, PhD, both from University of Glasgow, cautioned that the population is restricted to health care workers; therefore, the findings may not necessarily be generalized to a community population .

“Healthcare workers do not reflect the population of individuals most clinically affected by COVID-19 illness. The severity of acute COVID-19 infection is greatest in older individuals and those with preexisting health problems. Healthcare workers are not representative of the wider, unselected, at-risk, community population,” they pointed out.

Cardiovascular risk factors and concomitant health problems (heart and respiratory disease) may be more common in the community than in health care workers, and prior studies have highlighted their potential impact for disease pathogenesis in COVID-19.

Dr. Berry and Dr. Mangion also noted that women made up nearly two-thirds of the seropositive group. This may reflect a selection bias or may naturally reflect the fact that proportionately more women are asymptomatic or have milder forms of illness, whereas severe SARS-CoV-2 infection requiring hospitalization affects men to a greater degree.

COVIDsortium funding was donated by individuals, charitable trusts, and corporations including Goldman Sachs, Citadel and Citadel Securities, The Guy Foundation, GW Pharmaceuticals, Kusuma Trust, and Jagclif Charitable Trust, and enabled by Barts Charity with support from UCLH Charity. The authors have disclosed no relevant financial relationships.

A version of this article first appeared on Medscape.com.

Key clinical point: RA patients who switched from oral to subcutaneous methotrexate reported an increased quality of life and reduced symptoms.

Major finding: The proportion of RA patients with symptom remission or low disease activity increased from 22.8% to 52.9% after changing from oral to subcutaneous delivery of methotrexate, combined with a dose increase in 34.8% of patients.

Study details: The data come from a prospective, observational study of 207 adults with RA who switched from oral to subcutaneous methotrexate; 6.7% were in remission and 15.5% had low disease activity at baseline.

Disclosures: The study was supported by NORDIC Pharma. Several study coauthors disclosed relationships with NORDIC Pharma, and several are employees of NORDIC Pharma.

Source: Senbel E et al. Patient Prefer Adherence. 2021 Apr 14. doi: 10.2147/PPA.S301010.

Key clinical point: RA patients who switched from oral to subcutaneous methotrexate reported an increased quality of life and reduced symptoms.

Major finding: The proportion of RA patients with symptom remission or low disease activity increased from 22.8% to 52.9% after changing from oral to subcutaneous delivery of methotrexate, combined with a dose increase in 34.8% of patients.

Study details: The data come from a prospective, observational study of 207 adults with RA who switched from oral to subcutaneous methotrexate; 6.7% were in remission and 15.5% had low disease activity at baseline.

Disclosures: The study was supported by NORDIC Pharma. Several study coauthors disclosed relationships with NORDIC Pharma, and several are employees of NORDIC Pharma.

Source: Senbel E et al. Patient Prefer Adherence. 2021 Apr 14. doi: 10.2147/PPA.S301010.

Key clinical point: RA patients who switched from oral to subcutaneous methotrexate reported an increased quality of life and reduced symptoms.

Major finding: The proportion of RA patients with symptom remission or low disease activity increased from 22.8% to 52.9% after changing from oral to subcutaneous delivery of methotrexate, combined with a dose increase in 34.8% of patients.

Study details: The data come from a prospective, observational study of 207 adults with RA who switched from oral to subcutaneous methotrexate; 6.7% were in remission and 15.5% had low disease activity at baseline.

Disclosures: The study was supported by NORDIC Pharma. Several study coauthors disclosed relationships with NORDIC Pharma, and several are employees of NORDIC Pharma.

Source: Senbel E et al. Patient Prefer Adherence. 2021 Apr 14. doi: 10.2147/PPA.S301010.

Key clinical point: Stimulation with IL-33 showed an increase in several mast cell lines in RA patients compared to controls, suggesting that inhibiting mast cells might be a therapeutic strategy to prevent joint deterioration in RA patients.

Major finding: Synovial tissues in RA patients showed more more c-kit- and FcεRI-positive mast cells, which are producers of both tryptase and chymase, compared to controls after stimulation with IL-33. In addition, IL-33-stimulated mast cells promoted more osteoclast differentiation than non-stimulated mast cells.

Study details: The data come from synovial fluid samples collected from 20 RA patients and 20 patients with osteoarthritis of knee joints who served as controls. 

Disclosures: The study was supported in part by grants from the National Research Foundation of Korea. The researchers had no financial conflicts to disclose.  

Source: Kim K-W et al. Arthritis Res Ther. 2021 Apr 21. doi: 10.1186/s13075-021-02491-1.

Key clinical point: Stimulation with IL-33 showed an increase in several mast cell lines in RA patients compared to controls, suggesting that inhibiting mast cells might be a therapeutic strategy to prevent joint deterioration in RA patients.

Major finding: Synovial tissues in RA patients showed more more c-kit- and FcεRI-positive mast cells, which are producers of both tryptase and chymase, compared to controls after stimulation with IL-33. In addition, IL-33-stimulated mast cells promoted more osteoclast differentiation than non-stimulated mast cells.

Study details: The data come from synovial fluid samples collected from 20 RA patients and 20 patients with osteoarthritis of knee joints who served as controls. 

Disclosures: The study was supported in part by grants from the National Research Foundation of Korea. The researchers had no financial conflicts to disclose.  

Source: Kim K-W et al. Arthritis Res Ther. 2021 Apr 21. doi: 10.1186/s13075-021-02491-1.

Key clinical point: Stimulation with IL-33 showed an increase in several mast cell lines in RA patients compared to controls, suggesting that inhibiting mast cells might be a therapeutic strategy to prevent joint deterioration in RA patients.

Major finding: Synovial tissues in RA patients showed more more c-kit- and FcεRI-positive mast cells, which are producers of both tryptase and chymase, compared to controls after stimulation with IL-33. In addition, IL-33-stimulated mast cells promoted more osteoclast differentiation than non-stimulated mast cells.

Study details: The data come from synovial fluid samples collected from 20 RA patients and 20 patients with osteoarthritis of knee joints who served as controls. 

Disclosures: The study was supported in part by grants from the National Research Foundation of Korea. The researchers had no financial conflicts to disclose.  

Source: Kim K-W et al. Arthritis Res Ther. 2021 Apr 21. doi: 10.1186/s13075-021-02491-1.

Key clinical point: In an analysis of blood-derived CD19+ B cells, miRNAs may have regulatory functions in RA patients treated with methotrexate.

Major finding: Differences in expression were noted for 27 microRNAs between methotrexate patients and controls, but no significant differences between newly diagnosed patients and controls. Some of the differentially expressed miRNAs were dysregulated in RA patients including miR-223-3p, miR-486-3p and miR-23a-3p. 

Study details: The data come from small RNA sequencing of 10 newly diagnosed untreated RA patients (n=10), 18 successfully methotrexate (MTX) treated RA patients in remission, and 9 healthy controls.

Disclosures: The study was supported in part by Helse Sør-Øst Grants. The researchers had no financial conflicts to disclose.

Source: Heinicke F et al. Front Immunol. 2021 Apr 9. doi: 10.3389/fimmu.2021.663736.

Key clinical point: In an analysis of blood-derived CD19+ B cells, miRNAs may have regulatory functions in RA patients treated with methotrexate.

Major finding: Differences in expression were noted for 27 microRNAs between methotrexate patients and controls, but no significant differences between newly diagnosed patients and controls. Some of the differentially expressed miRNAs were dysregulated in RA patients including miR-223-3p, miR-486-3p and miR-23a-3p. 

Study details: The data come from small RNA sequencing of 10 newly diagnosed untreated RA patients (n=10), 18 successfully methotrexate (MTX) treated RA patients in remission, and 9 healthy controls.

Disclosures: The study was supported in part by Helse Sør-Øst Grants. The researchers had no financial conflicts to disclose.

Source: Heinicke F et al. Front Immunol. 2021 Apr 9. doi: 10.3389/fimmu.2021.663736.

Key clinical point: In an analysis of blood-derived CD19+ B cells, miRNAs may have regulatory functions in RA patients treated with methotrexate.

Major finding: Differences in expression were noted for 27 microRNAs between methotrexate patients and controls, but no significant differences between newly diagnosed patients and controls. Some of the differentially expressed miRNAs were dysregulated in RA patients including miR-223-3p, miR-486-3p and miR-23a-3p. 

Study details: The data come from small RNA sequencing of 10 newly diagnosed untreated RA patients (n=10), 18 successfully methotrexate (MTX) treated RA patients in remission, and 9 healthy controls.

Disclosures: The study was supported in part by Helse Sør-Øst Grants. The researchers had no financial conflicts to disclose.

Source: Heinicke F et al. Front Immunol. 2021 Apr 9. doi: 10.3389/fimmu.2021.663736.

Key clinical point: Rheumatoid arthritis patients taking a combination of methotrexate and JAKi showed no increased risk of malignancy compared to RA patients on methotrexate alone.

Major finding: No significant differences in overall malignancy appeared between methotrexate /JAKi combination patients compared to methotrexate-only patients (risk ratio 1.42); no differences appeared between the groups for nonmelanoma skin cancer (RR 1.44), malignancies excluding nonmelanoma skin cancer (RR 1.12), serious adverse events (RR 1.15), or deaths (RR 1.99).

Study details: The data come from a meta-analysis of 13 randomized, controlled trials with a total of 6,911 RA patients who received methotrexate and Janus kinase inhibitors (JAKi) 

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Solipuram V et al. Auto Immune Highlights. 2021 Apr 28. doi: 10.1186/s13317-021-00153-5.

Key clinical point: Rheumatoid arthritis patients taking a combination of methotrexate and JAKi showed no increased risk of malignancy compared to RA patients on methotrexate alone.

Major finding: No significant differences in overall malignancy appeared between methotrexate /JAKi combination patients compared to methotrexate-only patients (risk ratio 1.42); no differences appeared between the groups for nonmelanoma skin cancer (RR 1.44), malignancies excluding nonmelanoma skin cancer (RR 1.12), serious adverse events (RR 1.15), or deaths (RR 1.99).

Study details: The data come from a meta-analysis of 13 randomized, controlled trials with a total of 6,911 RA patients who received methotrexate and Janus kinase inhibitors (JAKi) 

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Solipuram V et al. Auto Immune Highlights. 2021 Apr 28. doi: 10.1186/s13317-021-00153-5.

Key clinical point: Rheumatoid arthritis patients taking a combination of methotrexate and JAKi showed no increased risk of malignancy compared to RA patients on methotrexate alone.

Major finding: No significant differences in overall malignancy appeared between methotrexate /JAKi combination patients compared to methotrexate-only patients (risk ratio 1.42); no differences appeared between the groups for nonmelanoma skin cancer (RR 1.44), malignancies excluding nonmelanoma skin cancer (RR 1.12), serious adverse events (RR 1.15), or deaths (RR 1.99).

Study details: The data come from a meta-analysis of 13 randomized, controlled trials with a total of 6,911 RA patients who received methotrexate and Janus kinase inhibitors (JAKi) 

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Solipuram V et al. Auto Immune Highlights. 2021 Apr 28. doi: 10.1186/s13317-021-00153-5.

Key clinical point: Current smoking was an independent predictor of inadequate response to methotrexate in treatment-naïve rheumatoid arthritis patients.

Major finding: Inadequate response to methotrexate, demonstrated by failure to achieve low disease activity, was significantly associated with current smoking (adjusted odds ratio 1.79). Lack of EULAR response also was significantly associated with current smoking (aOR 2.04).

Study details: The data come from a retrospective cohort study of 294 rheumatoid arthritis patients (60.5% women) who were naïve to disease modifying anti-rheumatic drugs.  

Disclosures: The study was supported by an unconditioned research grant from Pfizer. The researchers had no financial conflicts to disclose.

Source: Floris A et al. Medicine. 2021 Apr 30. doi: 10.1097/MD.0000000000025481.

Key clinical point: Current smoking was an independent predictor of inadequate response to methotrexate in treatment-naïve rheumatoid arthritis patients.

Major finding: Inadequate response to methotrexate, demonstrated by failure to achieve low disease activity, was significantly associated with current smoking (adjusted odds ratio 1.79). Lack of EULAR response also was significantly associated with current smoking (aOR 2.04).

Study details: The data come from a retrospective cohort study of 294 rheumatoid arthritis patients (60.5% women) who were naïve to disease modifying anti-rheumatic drugs.  

Disclosures: The study was supported by an unconditioned research grant from Pfizer. The researchers had no financial conflicts to disclose.

Source: Floris A et al. Medicine. 2021 Apr 30. doi: 10.1097/MD.0000000000025481.

Key clinical point: Current smoking was an independent predictor of inadequate response to methotrexate in treatment-naïve rheumatoid arthritis patients.

Major finding: Inadequate response to methotrexate, demonstrated by failure to achieve low disease activity, was significantly associated with current smoking (adjusted odds ratio 1.79). Lack of EULAR response also was significantly associated with current smoking (aOR 2.04).

Study details: The data come from a retrospective cohort study of 294 rheumatoid arthritis patients (60.5% women) who were naïve to disease modifying anti-rheumatic drugs.  

Disclosures: The study was supported by an unconditioned research grant from Pfizer. The researchers had no financial conflicts to disclose.

Source: Floris A et al. Medicine. 2021 Apr 30. doi: 10.1097/MD.0000000000025481.

Key clinical point: Diagnostic delay was an independent predictor of mortality in RA patients with interstitial lung disease in a multivariate analysis.

Major finding: Diagnostic delay was significantly associated with increased risk of mortality in adults with RA and interstitial lung disease (hazard ratio 1.11), along with age, severe oxygen desaturation on effort (SatO2) and diffusion capacity for carbon monoxide (DLCO); with hazard ratios of 1.33, 0.85, and 0.62, respectively.   

Study details: The data come from a multicenter study of 106 consecutive adults with rheumatoid arthritis and interstitial lung disease.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Cano-Jiménez E et al. Sci Rep. 2021 Apr 28. doi: 10.1038/s41598-021-88734-2.

Key clinical point: Diagnostic delay was an independent predictor of mortality in RA patients with interstitial lung disease in a multivariate analysis.

Major finding: Diagnostic delay was significantly associated with increased risk of mortality in adults with RA and interstitial lung disease (hazard ratio 1.11), along with age, severe oxygen desaturation on effort (SatO2) and diffusion capacity for carbon monoxide (DLCO); with hazard ratios of 1.33, 0.85, and 0.62, respectively.   

Study details: The data come from a multicenter study of 106 consecutive adults with rheumatoid arthritis and interstitial lung disease.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Cano-Jiménez E et al. Sci Rep. 2021 Apr 28. doi: 10.1038/s41598-021-88734-2.

Key clinical point: Diagnostic delay was an independent predictor of mortality in RA patients with interstitial lung disease in a multivariate analysis.

Major finding: Diagnostic delay was significantly associated with increased risk of mortality in adults with RA and interstitial lung disease (hazard ratio 1.11), along with age, severe oxygen desaturation on effort (SatO2) and diffusion capacity for carbon monoxide (DLCO); with hazard ratios of 1.33, 0.85, and 0.62, respectively.   

Study details: The data come from a multicenter study of 106 consecutive adults with rheumatoid arthritis and interstitial lung disease.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Cano-Jiménez E et al. Sci Rep. 2021 Apr 28. doi: 10.1038/s41598-021-88734-2.

Key clinical point: Rheumatic immune-related adverse events occurred in approximately one-third of cancer patients on immune checkpoint inhibitor (ICI) therapy.

Major finding: A total of 37.3% of patients on ICI therapy experienced at least one immune-related adverse event; 4.3% of patients experienced at least one rheumatic immune-related adverse event (rh-irAEs) and 3 of these patients had pre-existing rheumatic disease.

Study details: The data come from 437 adult cancer patients who were treated with ipilimumab and/or nivolumab, or pembrolizumab at a single center between January 2014 and December 2018.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Verspohl SH et al. Ther Adv Musculoskelet Dis. 2021 Apr 12. doi: 10.1177/1759720X211006963.

Key clinical point: Rheumatic immune-related adverse events occurred in approximately one-third of cancer patients on immune checkpoint inhibitor (ICI) therapy.

Major finding: A total of 37.3% of patients on ICI therapy experienced at least one immune-related adverse event; 4.3% of patients experienced at least one rheumatic immune-related adverse event (rh-irAEs) and 3 of these patients had pre-existing rheumatic disease.

Study details: The data come from 437 adult cancer patients who were treated with ipilimumab and/or nivolumab, or pembrolizumab at a single center between January 2014 and December 2018.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Verspohl SH et al. Ther Adv Musculoskelet Dis. 2021 Apr 12. doi: 10.1177/1759720X211006963.

Key clinical point: Rheumatic immune-related adverse events occurred in approximately one-third of cancer patients on immune checkpoint inhibitor (ICI) therapy.

Major finding: A total of 37.3% of patients on ICI therapy experienced at least one immune-related adverse event; 4.3% of patients experienced at least one rheumatic immune-related adverse event (rh-irAEs) and 3 of these patients had pre-existing rheumatic disease.

Study details: The data come from 437 adult cancer patients who were treated with ipilimumab and/or nivolumab, or pembrolizumab at a single center between January 2014 and December 2018.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Verspohl SH et al. Ther Adv Musculoskelet Dis. 2021 Apr 12. doi: 10.1177/1759720X211006963.