News in brief: Musculoskeletal imaging meeting; Differential WBC in lupus; COVID-19 vaccination for osteoporosis patients

Thursday, 18 Mar 2021

Australasian Musculoskeletal Imaging Group meeting

Rheumatologists are invited to join radiology and other colleagues at the Australasian Musculoskeletal Imaging Group (AMSIG) Annual Scientific Meeting.

The presentations, featuring a local and international faculty, will largely focus on rheumatological and soft tissue tumour imaging.

Sessions include:

  • Imaging of the sacroiliac joint and what a rheumatologist wants in the report.
  • Imaging the spine, “phytes” and diffuse idiopathic skeletal hyperostosis (DISH)
  • Imaging the peripheral joints especially the hand and wrist
  • Dual energy CT for gout
  • Imaging findings in fatty, cartilaginous and superficial soft tissue tumours and their mimicks
  • Incidental imaging findings in the vertebra, ribs, and long bones

The meeting is the principal event for musculoskeletal radiologists in the Oceania region.

AMSIG ASM is a virtual event to be held 8-9 May, 2021.

More discrimination in the differential WBC in lupus

Lymphopenia and neutropenia are common findings in SLE patients.

Data from more than 2,000 patients in the Asia Pacific Lupus Collaboration cohort, found 43.7% of patients had at least one episode of leucopenia. Specifically, 37.2% had lymphopenia and 12.5% had neutropenia.

The study found lymphopenia was associated with overall disease activity, ESR, serology, prednisolone, azathioprine, methotrexate, tacrolimus, cyclophosphamide and rituximab use. Methotrexate and ciclosporin were negatively associated with neutropenia.

Lupus low disease activity state (LLDAS) was negatively associated with both lymphopenia and neutropenia.

Lymphopenia and neutropenia should be considered independently in studies in SLE, the study concluded.


Guidance on COVID-19 for osteoporosis patients

Patients with osteoporosis do not appear to be at any increased risk for SARS-CoV-2 infection or for complications from COVID-19 disease and therefore do not need to be prioritised for COVID-19 vaccination.

Similarly, osteoporosis therapy does not appear to increase the risk or severity of COVID-19 infection.

However Joint Guidance on COVID-19 Vaccination and Osteoporosis Management from the Endocrine Society, ASBMR, IOF and other organisations outlines some medication-specific considerations.

They include:

  • Oral bisphosphonates should be continued without interruption or delay in patients receiving COVID-19 vaccination.
  • A one week interval between IV bisphosphonate infusion and COVID-19 vaccination will allow for distinguishing between putative acute phase reactions resulting from either IV bisphosphonate administration or COVID-19 vaccination.
  • An interval of 4-7 days between treatment with denosumab and COVID-19 vaccination allows for the potential occurrence of injection site reactions with either treatment. Alternatively, denosumab treatment could be administered in the contralateral arm or alternative site (abdomen or upper thigh) if it is necessary to administer concomitantly with COVID-19 vaccine.
  • While denosumab timing may be slightly adjusted to account for vaccine timing, denosumab injections should not be delayed more than 7 months after the previous denosumab dose.
  • Both teriparatide and abaloparatide should be continued in patients receiving COVID-19 vaccination.
  • An interval of 4-7 days between romosozumab and COVID-19 vaccination, or consideration for injection in the abdomen (except for a two-inch area around the navel) or thigh if administered concomitantly.
  • Raloxifene should be continued in patients receiving COVID-19 vaccination.

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