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The American College of Rheumatology (ACR) has recently issued conditional recommendations on the coronavirus disease 2019 (COVID-19) vaccination for rheumatology patients with musculoskeletal, inflammatory, and autoimmune diseases. The recommendations are focused on the 2 mRNA COVID-19 vaccines currently available in the United States and are based on experience using immunomodulatory medications with other vaccines. The recommendations will be reviewed as additional COVID-19 vaccines are approved for use and more information on vaccine response specific to rheumatic disease patients emerges. Test your knowledge of the special considerations recommended for COVID-19 vaccination of patients with rheumatic diseases.

A study published in Osteoporosis International focused on the changes that have occurred over the course of the pandemic for patients with osteoporosis and found that there have been delays in dual-energy X-ray absorptiometry (DXA) scanning, problems with medication supply, a decrease in face-to-face consultations, and reductions in parenteral medication delivery.

Tocilizumab is an interleukin 6 (an inflammatory cytokine) inhibitor approved for treating a variety of rheumatic diseases, including rheumatoid arthritis. As studies have shown that an increased level of interleukin 6 directly correlates to poor COVID-19 outcomes, investigators speculated that blocking this activity could be a helpful tool in treating the virus and lessening its severity.

Dr Joan Lo, MD, a research scientist with the Kaiser Permanente Northern California Division of Research, said: “We found that hip fracture risk in women did not differ if women stopped bisphosphonate use after five years or stayed on the medication for 10 years. Whether there is a benefit to staying on the drug for seven years needs to be further studied in randomized trials.”