New COVID-19 vaccination approach for rituximab patients

Vaccination against COVID-19 for rheumatic disease patients taking anti-CD20 therapy such as rituximab can be informed by new findings on CD4+ T-helper-cell counts as an immune biomarker, according to German researchers.

In a study published in Lancet Rheumatology they confirmed that patients taking B-cell-depleting therapies showed blunted or negligible humoral and cell-mediated immune responses SARS-CoV-2 vaccination.

Four factors were identified that were associated with high antibody titres after immunisation in patients on B-cell-depleting therapies: higher numbers of circulating B cells and CD4 T cells, higher concentrations of IgM, and a longer time since the last infusion of B-cell-depleting agent.

While vaccination strategies based on a rigid CD20-depletion interval or peripheral B-cell count would render many patients ineligible, the researchers said their findings suggested other factors such as CD4+ T-helper-cell counts  and a seven month interval after stopping therapy may be used to inform vaccination .

In-person medical conferences resume for ASBMR

The American Society for Bone and Mineral Research (ASBMR) 2021 Annual Meeting has announced it will convene in-person this year in San Diego, California, from 1-4 October.

After running virtual meetings during the COVID-19 pandemic, the ASBMR says it is now ready to offer an in-person meeting for clinicians and researchers to discuss bone and musculoskeletal health.

While it will still be offering a “a synchronous virtual experience” option, the ASBMR says it will be welcoming delgates who can prove they are fully vaccinated with a WHO-approved vaccine against COVID-19, and the in-person meeting will require delegatesd to wear a mask indoors at all times

The meeting will include highlights such as presentations on  AI-assisted hip fracture prevention, the long-term effects of epidural steroid injections on bone formation, and the musculoskeletal complications of COVID-19 infection and lockdowns.

Global medical journals call for emergency action on climate crisis

More than 230 international medical journals are standing together to demand urgent action on climate change, in a bid to prevent further catastrophic harm to health.

In an unprecedented move, the journals have simultaneously published a joint editorial calling on governments to halt the destruction of nature, protect health, and create “a sustainable, fairer, resilient, and healthier world,” ahead of this month’s UN General Assembly climate conference in Glasgow, UK. 

The editorial, published in titles such as Rheumatology, Annals of the Rheumatic Diseases, the Lancet Rheumatology, RMD Open, New England Journal of Medicine and The BMJ, warns that the greatest threat to global public health is the failure of world leaders to take sustained and effective action to rein in global temperature rises. 

Recent targets to reduce emissions and conserve nature are welcome but do not go far enough, and “are yet to be matched with credible short and longer term plans to accelerate cleaner technologies and transform societies”, it said. 

Insufficient action means that temperature rises “well in excess” of 2°C are now likely, which would represent a “catastrophic outcome for health and environmental stability”.

Addressing the climate threat will require a similar level of funding as that made available by the government in the fight against COVID-19, the authors said. “Huge investment will be needed, beyond what is being considered or delivered anywhere in the world. But such investments will produce huge positive health and economic outcomes.”

Dr Fiona Godlee, Editor-in-Chief of The BMJ, and one of the co-authors of the editorial, said healthcare professionals who have been on the frontline of the COVID-19 crisis “are united in warning that going above 1.5C and allowing the continued destruction of nature will bring the next, far deadlier crisis”. “2021 has to be the year the world changes course – our health depends on it.”

The editorial was coordinated by the UK Health Alliance on Climate Change.