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The American College of Rheumatology (ACR) has recently issued conditional recommendations on the coronavirus disease 2019 (COVID-19) vaccination for rheumatology patients with musculoskeletal, inflammatory, and autoimmune diseases. The recommendations are focused on the 2 mRNA COVID-19 vaccines currently available in the United States and are based on experience using immunomodulatory medications with other vaccines. The recommendations will be reviewed as additional COVID-19 vaccines are approved for use and more information on vaccine response specific to rheumatic disease patients emerges. Test your knowledge of the special considerations recommended for COVID-19 vaccination of patients with rheumatic diseases.

A study published in Osteoporosis International focused on the changes that have occurred over the course of the pandemic for patients with osteoporosis and found that there have been delays in dual-energy X-ray absorptiometry (DXA) scanning, problems with medication supply, a decrease in face-to-face consultations, and reductions in parenteral medication delivery.

Take 5 minutes to catch up on Rheumatology Network's highlights from the week ending February 12, 2021.

An international survey shows an increase in telemedicine, but a decrease in out-patient care.

Dr David R. Karp, president of the American College of Rheumatology (ACR), outlines some of the legislative and regulatory developments of last year that had significant impacts on rheumatology practices and provides a policy outlook for the year ahead.

Investigators set out to explore sedentary behavior, physical and mental limitations, the willingness of this patient population to engage in more regular exercise, how perceptive they were to using technology to support a more active lifestyle, and interventions to reduce sedentary time.

Patients with rheumatoid arthritis are known to have a greater risk of serious infections related both to the disease itself and its treatment. What can be done to reduce that risk? Test your knowledge with this quiz.

Take 5 minutes to catch up on Rheumatology Network's highlights from the week ending February 5, 2021.

In this 48-week, phase 3, randomized controlled trial, investigators examined patient-reported outcomes of patients with psoriatic arthritis receiving methotrexate monotherapy, etanercept monotherapy, or a combination of both drugs.

Tocilizumab is an interleukin 6 (an inflammatory cytokine) inhibitor approved for treating a variety of rheumatic diseases, including rheumatoid arthritis. As studies have shown that an increased level of interleukin 6 directly correlates to poor COVID-19 outcomes, investigators speculated that blocking this activity could be a helpful tool in treating the virus and lessening its severity.

Children who received methylprednisolone added to intravenous immunoglobulins experienced lower risk of treatment failure and use of second-line therapy

The primary objective of this retrospective study was to understand why Latino patients were being disproportionately affected by COVID-19. Of the patients observed, 32 (18%) developed COVID-19 during the study period, meaning incidence rates were 5- to 11-fold higher than the general population (1,540 to 3,431/100,000).

This week's rheumatoid arthritis quiz was developed by Fotios Koumpouras, MD, Director of Education and Training and Director of the Yale Lupus Program at Yale School of Medicine.

In a new study, investigators set out to discover whether the Janus kinase-1 inhibitor filgotinib is efficacious, either in combination with MTX or as monotherapy, in patients with RA who have had limited or no MTX exposure.

Investigators determined, “Treatment with TNF inhibitors is not associated with increased risks of solid cancer overall, or eight common cancer types. There were no indications of different crude incidence of solid cancers overall by TNF inhibitor agent.”

A recent study published in The Journal of Rheumatology found no association between hydroxychloroquine therapy and heart failure in patients with rheumatoid arthritis (RA) and other rheumatic diseases, such as systemic lupus erythematous (SLE).

Increasing dosage of mometasone is associated with elevated risk of osteoporosis and major osteoporotic fractures.

The treatment is the first approved medication for this patient population.

Despite the limitations of the study, non-adherence rates were significantly reduced in patients observed throughout the 3 years, indicating that the methods developed and deployed were successful.

Voclosporin (LUPKYNIS), in combination with an existing immunosuppressive therapy regimen, works to safely and effectively treat adult patients with lupus nephritis.

Alyssa Johnsen, MD, PhD, shares her insight on the importance of understanding key pathways that drive immune-mediated diseases, which can help rheumatologists develop more potent and specific therapies for patients with rheumatic disease.

“Based on 16,235 pairs of zoledronic acid and denosumab initiators (for osteoporosis), we found a greater risk (HR 1.25, 95% CI 1.04-1.50) of atrial fibrillation with zoledronic acid vs denosumab: an absolute risk difference of 3.69 events per 1000 person-years,” said Seoyoung Kim, MD, ScD.

Investigators aimed to improve the quality of care by creating effective management plans using the goals of both the patient and physician. During the course of the Elderly Multimorbidity Clinic (EMC) program, 75% of patients accomplished at least 1 of their goals. Unfortunately, no sustained benefits were observed because of low follow-up.

Improvement in ASAS20 (Assessment of SpondyloArthritis international Society) was seen in 63% of participants assigned to secukinumab 300 mg and 66% of those assigned to secukinumab 150 mg, versus 31% of the placebo group.

Investigators found "improved outcomes for patients with rheumatic and musculoskeletal diseases after COVID-19 diagnosis in more recent months of the pandemic compared with earlier months, including lower risks of death, respiratory failure, and renal failure."

The VELYS Robotic-Assisted solution will be used in conjunction with the VELYS Digital Surgery Platform.

Dr Joan Lo, MD, a research scientist with the Kaiser Permanente Northern California Division of Research, said: “We found that hip fracture risk in women did not differ if women stopped bisphosphonate use after five years or stayed on the medication for 10 years. Whether there is a benefit to staying on the drug for seven years needs to be further studied in randomized trials.”

“The most important take home message for rheumatologists is that we can predict lack of response to methotrexate by analyzing the fecal microbiome of patients before the initiation of the treatment,” said Jose Scher, MD, rheumatologist from the Department of Medicine, Mount Sinai School of Medicine, New York.

Although the stakes couldn’t be higher and the promotion of healthy behavior is paramount, the emphasis on BMI and weight is likely to yield little benefit. The Association for Size Diversity and Health (ASDAH) developed Health at Every Size (HAES) to take the focus off of weight change and place it more squarely on health, thus supporting people of all sizes to take care of themselves and improve health outcomes.

Investigators compared a self-directed, stepped exercise program to improve symptoms of knee osteoarthritis in randomized trial to an education-based approach.