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July 6, 2022

Top tweets: Appropriate use of injectable steroids and more

Clinical Trials Arena lists five of the top tweets on immunology in Q2 2022 based on data from GlobalData’s Pharmaceuticals Influencer Platform.

The top tweets are based on total engagements (likes and retweets) received on tweets from more than 72 immunology experts tracked by GlobalData’s Pharmaceuticals Influencer platform during the second quarter (Q2) of 2022.

1. Adam Meakins’ tweet on the appropriate use of injectable steroids

Adam Meakins, a specialist sports physiotherapist and extended scope practitioner, tweeted on the appropriate use of steroid injections, citing four among the five cases to have entered his clinic for ultrasound guided steroid shoulder injections to be inappropriate. The cases included symptoms such as minimal pain or disability, clearly radicular arm pain, four previous failed injections, and unstable diabetes. He further suggested that steroid injections were not to be used as a first line treatment for mild or minor symptoms, especially for those without a clear diagnosis and in those with any contraindications.

Contraindications or conditions that did not require the use of steroid injections, he added, included a fractured bone or ruptured tendon, hemoarthrosis, an osteonecrotic joint, a prosthetic joint, an active infection, immunodeficiency, a known allergic response, unstable diabetes, anticoagulation drugs, and conditions that went without a diagnosis.

Username: The Sports Physio

Twitter handle: @AdamMeakins

Likes: 222

Retweets: 28

2. David Hunter’s tweet on the safety of steroid injections prior to surgery

David Hunter, a professor of medicine at the University of Sydney and the Royal North Shore Hospital, shared a research on the safety of intraarticular corticosteroid injection (ICSI) before a hip and knee arthroplasty. A review comparing the odds of prosthetic joint infection (PJI) in patients who were or were not administered ICSI within a year prior to hip or knee arthroplasty in 12 studies, including four with 209,353 hips and eight with 438,440 knees, found significantly higher risks of PJI in patients receiving ICSI within 12 months before a hip replacement surgery.

A subgroup analysis further revealed increased odds of PJI in both hip and knee arthroplasty, if ICSI was administered in patients within three months prior to their arthroplasty, the paper detailed. Researchers thereby suggested delaying knee arthroplasty for a period of at least three months after ICSI and preferably longer for hip arthroplasty.

Username: David Hunter

Twitter handle: @ProfDavidHunter

Likes: 114

Retweets: 32

3. Frits Franssen’s tweet on the benefits of pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis (IPF)

Frits Franssen, a respiratory physician and professor, shared a real-world study on the benefits of pulmonary rehabilitation in patients with IPF when matched 1:1 with a control group of 163 patients with chronic obstructive pulmonary disease (COPD). The study focused on assessing whether people with IPF improved to the same extent with pulmonary rehabilitation as individuals with COPD, and whether the noncompletion of or nonresponse to pulmonary rehabilitation, or both, were related with a one-year all-cause mortality in IPF.

The findings revealed that patients with IPF had the same completion rates and response to pulmonary rehabilitation as compared to individuals with COPD. In addition, noncompletion of and nonresponse to pulmonary rehabilitation were linked to increased all-cause mortality in patients with IPF. Among the 163 patients with IPF, six died before completing pulmonary rehabilitation, while 42 (27%) of the remaining 157 died in the one-year follow-up period.

Username: Frits Franssen

Twitter handle: @fritsfranssen

Likes: 53

Retweets: 19

4. Dr. John Cush’s tweet on FDA’s approval of RINVOQ® for adults with active ankylosing spondylitis

Dr. John Cush, a rheumatologist, shared an article on the US Food and Drug Administration (FDA) approving RINVOQ® (upadacitinib) as an oral treatment for adults with active ankylosing spondylitis (AS) who have had an adequate response or are intolerant to one or more tumour necrosis factor (TNF) blockers. The drug’s approval by the FDA is based on the safety and efficacy data from a phase 3 SELECT-AXIS 2 clinical study and phase 2/3 SELECT-AXIS 1 clinical trial. The first study investigated the use of RINVOQ in patients who had an inadequate response or were intolerant to one or two biologic disease-modifying anti-rheumatic medications (bDMARDs), and the second evaluated RINVOQ in patients who were naive to bDMARDs and had an inadequate response or were intolerant to at least two non-steroidal anti-inflammatory drugs (NSAIDs), the article detailed.

In both the clinical trials, a significantly higher number of patients receiving RINVOQ achieved an ASAS40 response of 51% and primary endpoint of 44.5%, compared to those receiving placebo (26% and 18.2% respectively) in the fourteenth week. Clinical responses were observed as early as the fourth week in SELECT-AXIS 2 for ASAS40.

Username: Dr. John Cush

Twitter handle: @RheumNow

Likes: 54

Retweets: 18

5. Dr. Dave Stukus’s tweet on the oral allergy syndrome (OAS)

Dr. Dave Stukus, a professor of paediatrics and director of the Food Allergy Center at the Nationwide Children’s Hospital, shared an article on how OAS, also known as pollen-food syndrome, leads to excessive itching and irritation in the throat and mouth while eating fruits and vegetables in those suffering with pollen allergies. He further added that the symptoms can be worse if the pollen levels are high or if an individual’s allergies are aggressive.

Many fruits and vegetables contain similar proteins with that of outdoor pollens and can confuse the immune system, the article detailed. Unlike food allergy, OAS symptoms can be managed more easily as it progresses only to the mouth or throat, and does not require medical intervention. The cross-reactive proteins causing OAS can be  eliminated by cooking, canning, or peeling the fruits and vegetables, and OAS is treated by first diagnosing the allergy, followed by a skin prick test, the article further noted.

Username: Dr. Dave Stukus

Twitter handle:  @AllergyKidsDoc

Likes: 52

Retweets: 17

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