News in brief: Upadacitinib listed on PBS for AS and PsA; Paediatric patients with rheumatic disease have low COVID-19 risk; Urgent action needed on COVID-19 vax for people with disability 

Upadacitinib listed on PBS for AS and PsA

The JAK1 selective inhibitor upadacitinib (Rinvoq) is reimbursed on the PBS for adults patients with ankylosing spondylitis and psoriatic arthritis from 1 October, manufacturer Abbvie has announced.

The drug is available as an Authority Required (Written) item for eligible Australian adults living with severe active psoriatic arthritis (PsA) and active ankylosing spondylitis (AS).

The listing was welcomed by rheumatologist Associate Professor, Andrew Östör, who said: “Patients are searching for options to control their disease in order to live a normal life. However, the management pathway for rheumatic diseases can often be complicated and confusing. As every patient is different, it is imperative we have access to additional therapies to maximise long term outcomes.”

Paediatric patients with rheumatic disease have low COVID-19 risk

The risk of severe or critical COVID-19 in immunosuppressed paediatric rheumatic disease (RD) patients is minimal, according to the first report of clinical outcomes of SARS-CoV-2 infection and seroprevalence of SARS-CoV-2 IgG in a large cohort of paediatric RD patients.

A US study that investigated outcomes in 262 subjects (186 female) under the age of 18 using immunusuppressive therapy found that 13% were SARS-CoV-2 IgG+; of whom half (49%) had symptoms suggestive of COVID-19. The most common symptoms in IgG+ and/or PCR+ subjects were fever, fatigue, and cough. No SARS-CoV-2 IgG+ or PCR+ subject developed severe or critical COVID-19 or required hospitalisation.

The findings are published in Rheumatology.

RACP calls for urgent action on COVID-19 vaccination for people with disability

The Royal Australasian College of Physicians (RACP) has serious concerns that people living with disability have not been prioritised for COVID-19 vaccinations, as states prepare to ease restriction in a matter of days.

The RACP has repeatedly raised concerns about the slow rollout of the COVID-19 vaccines to people with disability and the need to urgently prioritise this group. Disability care residents and staff were in the highest priority group for vaccination yet only 67% of residents and 59% disability screened workers are vaccinated.

People with disability are at increased risk of adverse outcomes if they are infected by COVID-19. A study in the UK reported that 58% of COVID-19 deaths were among people who had a disability, whilst another UK study found people with intellectual disability were eight times more likely to die of COVID-19 than the general population.

Dr Jacqueline Small, RACP President-elect and developmental paediatrician said: “The DRC report that people living with disability were deprioritised in the vaccine rollout is deeply concerning. We have had months to get this right. Now we are days away from states easing restrictions with less than half of NDIS participants aged 16 years and over fully vaccinated – that is really troubling.

“A coordinated connected response with inclusion of people with disability, local health districts, primary health networks and non-government organisations is needed urgently.”

report released by the national organisation Children and Young People with Disability Australia has shown that over 70% of respondents experienced difficulties in securing vaccinations.

The RACP said the federal government must publish data on the COVID-19 vaccine rollout for people with disability to enable a quick response at a local level where gaps in accessibility are identified. This must include regular, up-to-date disaggregated data on the vaccination numbers for all people with disability, as at present only NDIS participant data is available publicly. It must also include the rates of COVID-19 infection and death amongst all people with disability.

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