Episode 63: COVID-19, Vaccinations, Shared-Decision Making, & Rheumy Communications

This week join your patient co-hosts, Tiffany Westrich-Robertson, CEO of the International Foundation for Autoimmune and Autoinflammatory Arthritis (AiArthritis), and recurring 2021 patient co-host Deb Constien as they welcome two special guests to the table for a new episode of our Special Series on COVID-19. They are joined today by two practicing adult rheumatologists: Dr. Al Kim ("Al") of the Washington University School of Medicine and Dr. Jeff Sparks ("Jeff") of the Harvard School of Medicine *. 

In this segment of the debrief, the rheumies update us on COVID-19 vaccinations and new research.  Jeff received an abstract award at the conference for his research on COVID-19 disease outcomes for patients taking immunosuppressant medications and Al is doing research, led by Washington University, tracking vaccine response in autoimmune patients. 

Shared decision making about therapeutic plans, including vaccination, is the other hot topic for the day! The rheumies and our co-hosts dish about the topics on patients’ minds including antibodies, boosters, and next steps. And Tiffany gives a special thank you to Janssen Pharmaceuticals for investing in the organizations new initiative to prepare patients to engage in shared decision making about COVID-19 and vaccines. 

 

This special episode was recorded during a EULAR 2021 debrief. You can watch the entire, unedited video recording (that also includes Katie and Patrice) HERE.  While there, watch all of our EULAR 2021 content on our YouTube Channel.

*Actually, at minute marker 20 in the full video, Al and Jeff zoom-bombed our patient-led debrief, the first time non-patient stakeholders were invited to the table for this series. But it was about rheumy communication, so why not?! 

 

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AiArthritis Voices 360 is produced by the International Foundation for Autoimmune and Autoinflammatory Arthritis. Visit us on the web at www.aiarthritis.org/talkshow. Find us on Twitter, Instagram, TikTok, or Facebook (@ifAiArthritis) or email us (podcast@aiarthritis.org).

 

Episode 63: COVID-19, Vaccinations, Shared-Decision Making, & Rheumy Communications

01:37 - Tiffany welcomes listeners.

03:12 - Tiffany is joined today by recurring co-host Deb and rheumatologists Dr Al Kim and Dr Jeff Sparks.

05:16 - Today’s episode will focus on COVID-19 vaccinations and new research on COVID-19, as well as the launch of a new AiArthritis initiative to promote shared decision making regarding COVID-19 vaccinations.

07:47 - Thank you to Johnson & Johnson for funding our work on this important initiative. 

09:01 - Jeff explains his award-winning research abstract presented at EULAR 2021.

10:33 - Jeff’s research found that COVID-19 patients who were taking Rituximab and JAK inhibitors prior to diagnosis had more severe disease courses compared to patients who were not treated with these drugs or were treated with different DMARD or Biologics.

10:58 - This is especially interesting because some trials have shown that JAK inhibitors can be effective in treating COVID-19 in patients who were not taking immunosuppressant medications prior to diagnosis.

13:19 - COVID-19 is a unique disease in that it creates a second stage inflammatory state where immunosuppressants can be helpful in preventing death and facilitating recovery.

13:48 - Research from Yale shows that a patient’s ability to produce antibodies effectively in the early stage of the disease is crucial to preventing the more serious form of the disease, so patients taking immunosuppressants have an increased risk of developing severe COVID even though these drugs are helpful in treating the disease in the second stage.

15:32 - AiArthritis (in conjunction with EULAR PARE) just launched the Pathway of Patient Engagement in Rheumatology Research, which features Jeff’s research abstract.

16:32 - What should patients be preparing for before their rheumatology appointments as new information about COVID-19 and vaccines continues to develop?

17:00 - Al still thinks that testing patients for antibodies doesn’t make sense because antibody status is not actionable information from the rheumatologist’s perspective.

17:47 - Prophylactic monoclonal antibodies are substantially restricted because they have only been approved under an Emergency Use Authorization by the FDA, so your rheumatologist cannot just prescribe them for you because your vaccine did not yield COVID-19 antibodies.

18:05 - Booster shots for COVID-19 have also not been approved by the FDA yet, so some patients are lying about their vaccination status to get a second set of shots.  Please note that neither AiArthritis nor the rheumatologists appearing in this episode recommend this course of action.

22:21 - Rituximab is generally considered to be a very safe drug, but it elevates risk for patients with COVID-19.

23:06 - This raises questions for doctors about whether they should continue prescribing it in light of the risk that patients may be facing from COVID-19.

23:15 - It will be very important for patients to engage in shared decision making with regard to drugs that elevate COVID-19 risks.

24:11 - Special thanks to Janssen Pharmaceuticals for their support in funding our work on promoting shared decision and helping patients with regard to COVID-19 vaccination decisions.

26:36 - To watch the entirety of this conversation, check out our EULAR debrief video #6 on our YouTube Channel.

26:55 - If you are interested in going to conferences with us, find out how you could attend a conference with us at aiarthritis.org/conferences.

27:11 - You can also find any of our previous podcast episodes at aiarthritis.org/talkshow.

27:17 - Please consider donating at aiarthritis.org because we need your support to keep this show and all of our initiatives moving forward.

27:54 - Tiffany thanks listeners for their support.

 

Links discussed in this debrief:

• 2021 EULAR recommendations for the implementation of self-management strategies in patients with inflammatory arthritis - https://ard.bmj.com/content/early/2021/06/13/annrheumdis-2021-220249
• Exploring intentional medication non-adherence in patients with systemic lupus erythematosus: the role of physician-patient interactions - https://pubmed.ncbi.nlm.nih.gov/33604502/
• Associations of baseline use of biologic or targeted synthetic DMARDs with COVID-19 severity in rheumatoid arthritis: Results from the COVID-19 Global Rheumatology Alliance physician registry - https://pubmed.ncbi.nlm.nih.gov/34049860/
• Glucocorticoids and B Cell Depleting Agents Substantially Impair
• Immunogenicity of mRNA Vaccines to SARS-CoV-2 - https://www.medrxiv.org/content/10.1101/2021.04.05.21254656v2.full.pdf
• Learn more about the Pathway of Patient Engagement in Rheumatology Research: www.rheumactioncouncil.org/pathway

 

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