The graph shows the percentage of patients with newly positive IgG COVID spike protein antibodies 2-4 weeks after their 2nd Pfizer mRNA vaccine shot

New Research: Antibody Levels After COVID Vaccine on Immunosuppressants

Some Immunosuppressant Drugs Cause Lower Antibody Levels after COVID Vaccine than do Other Drugs

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A large study was published in the Annals of Rheumatic Diseases showing antibody levels after COVID vaccine in patients on immunosuppressants. These drugs were taken by patients with systemic autoimmune diseases (such as rheumatoid arthritis, lupus, spondyloarthropathies, and vasculitis).

Since these drugs decrease immune system activity, it is not surprising that some of them appeared to lower the chances of someone responding to the COVID-19 vaccine. However, they varied a lot in how much they suppressed antibody responses. The investigators measured the most important antibody response called the SARS-CoV-2 spike S1/S2 proteins. Antibody levels were measured two to four weeks after the second vaccine dose of the Pfizer mRNA vaccine.

Remember that infections are in the top 3 causes of death in systemic lupus. It is important to get all vaccines as per “The Lupus Secrets.”

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Lupus Tendonitis: A Common Cause of Pain in Lupus Patients

Lupus tendonitis (lupus tendinitis), lupus tenosynovitis, and lupus enthesitis: What are they?

 
A lupus patient with Jaccoud's arthropathy due to lupus tendinitis (lupus tendonitis) and lupus tenosynovitis
 
Jaccoud’s arthropathy due to lupus tendinitis (lupus tendonitis) and lupus tenosynovitis
 

 

What is lupus tendonitis?

Lupus tendonitis (for example, lupus Achilles tendonitis) and tenosynovitis are common in systemic lupus erythematosus (SLE). The tendons are sinewy, inelastic fibrous tissue that connects the muscle to bone. When muscles contract to move parts of the body, these strong tendons enable the muscles to move the much stronger bones. The movement of these tendons in unison with the body’s muscles and joints allows us to move. To demonstrate tendons to yourself, place your left fingers on the front bend of your right elbow. Then, bend your right elbow. The muscle just above this is your biceps. The hard, long structures just below the biceps that connect to the bone below the bend are the biceps tendons. If these were to become inflamed and painful, this would be  “biceps tendonitis.” Just as lupus can cause joint inflammation, it can also cause tendon inflammation (lupus tendonitis or lupus tendonitis). Tendonitis causes pain around and between the joints of the body. SLE joint pains are commonly due to lupus tendonitis rather than arthritis. One Japanese study in 2017 showed that 94% of their SLE patients’ joint pains were actually lupus tendonitis. 80% had joint (arthritis) involvement. Many patients had both.
 

 

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The Pfizer COVID-19 RNA virus vaccine booster shot was studied in immunosuppressed patients: could a COVID booster vaccine for lupus patients be beneficial?

Immunosuppressed Patients Respond to Booster Shots: Hope for a COVID Booster Vaccine for Lupus and Other Autoimmune Disease Patients? [Updated 8/12/21]

 

Will a COVID Booster Vaccine for Lupus Patients Increase Response Rates?

We do not know, yet. However, the August 12, 2021 edition of the New England Journal of Medicine reported significant responses in immunosuppressed organ transplant patients. This provides hope that a COVID booster vaccine for lupus patients, and other autoimmune disease patients, who are immunosuppressed may also respond well.

The Problem: Early reports from COVID vaccine studies suggest that patients on immunosuppressants have lower response rates. The Johns Hopkins Hospital study has already suggested that patients on mycophenolate mofetil, rituximab, and steroids (when combined with another immunosuppressants) have high rates of nonresponse.

This leaves immunosuppressed patients, such as lupus patients, unsure of how well they responded to their COVID vaccines and they must remain vigilant with social distancing, mask wearing, etc. Unfortunately, the usual COVID antibody tests available to most doctors do not test for antibodies to the SARS-Cov-2 spike protein, which is essential to test for vaccine responses, so few patients know if they responded or not.

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Anifrolumab inhibits type 1 interferon from increasing immune system activity

Anifrolumab FDA approval to treat systemic lupus [Saphnelo]

Anifrolumab FDA Approval to Treat Systemic Lupus Erythematosus (SLE)

AstraZeneca announced its anifrolumab FDA approval on 8/2/2021. In this blog, learn how anifrolumab works, how it is given, and its potential side effects. If you are a patient with lupus that is not in remission, this brings you hope for a potentially better treatment, read more below. If you are a healthcare provider searching for detailed information on the indications, dosing, and precautions, read more below.

The anifrolumab brand name is Saphnelo

History was made when the U.S. Food and Drug Administration (FDA) gave final approval to use anifrolumab (Saphnelo) as a safe and effective treatment for SLE. Note that anifrolumab is the generic drug name, and Saphnelo is the trade (brand) name. It is produced by AstraZeneca.

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Now Research Shows: Lupus tendinitis, common cause of lupus pain

A lupus patient with Jaccoud's arthropathy due to lupus tendinitis (lupus tendonitis) and lupus tenosynovitis

Jaccoud’s arthropathy due to lupus tendinitis (lupus tendonitis) and lupus tenosynovitis

What is lupus tendinitis (also spelled lupus tendonitis)?

Lupus tendinitis (lupus tendonitis) and tenosynovitis are common in systemic lupus erythematosus (SLE). The tendons are sinewy, inelastic fibrous tissue that connects the muscles to the bones. When muscles contract to move parts of the body, these strong tendons enable the muscles to move the much stronger bones. The movement of these tendons in unison with the body’s muscles and joints allows us to move. To demonstrate tendons to yourself, place your left fingers on the front bend of your right elbow. Then, bend your right elbow. The muscle just above this is your biceps. The hard, long structures just below the biceps that connect to the bone below the bend are the biceps tendons. If these were to become inflamed and painful, this would be  “biceps tendonitis.”

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Benlysta Reviews: Learn the amazing truth on how it works [Updated]

 

Picture shows how Benlysta works by interfering with B cell proliferation
How Benlysta works: it decreases the activation of autoreactive B-cells that make bad autoantibodies such as ANA and anti-DNA 

The pink guys are lymphocytes (T-cells in this case) under electron microscopy. photo from Texas Center for Cancer Nanomedicine

 

Benlysta (belimumab) Decreases the Cells that Make Bad Antinuclear Antibodies: See Benlysta Reviews Below

 

Read this and other Benlysta reviews to learn how amazing Benlysta works. There are very good reasons why it has achieved 3 FDA approvals for lupus (systemic lupus erythematosus or SLE, pediatric lupus, and lupus nephritis) in the past 10 years. It is safe and effective per many Benlysta reviews. It is used as an IV treatment for lupus as well as a self-injectable form. Before you get your Benlysta first infusion or self-injection, make sure to learn as much as you can from this and other Benlysta reviews. Today, we use Benlysta for lupus nephritis, SLE, and pediatric lupus. 

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Make sure your urine sample is optimal when you have lupus

Man collecting a clean catch urine sample
It is essential for lupus patients to regularly collect an accurate clean catch urine sample

Why do lupus patients need to give a clean catch urine sample every 3 months?

Doing a clean catch urine sample wrong can cause false results

Around 40% of systemic lupus erythematosus patients develop kidney inflammation (nephritis) and need to give a clean catch urine sample on a regular basis. It is essential to always give a proper clean catch urine sample so that the results are accurate.

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“Do I need a mask after vaccination?” Now here is the truth

Male lupus patient with a mask

Please continue to protect yourself as you did before if you have lupus or another systemic autoimmune disease and are vaccinated against COVID-19

QUESTION OF THE DAY:

Dr. T. I have lupus. I got both of my Moderna COVID vaccines. Can I take off my mask like the CDC recommends?

ANSWER:

I am so glad you asked this question!

NO! (generally, see exceptions below)

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Moderna and Pfizer Vaccines: How Effective is One COVID shot?

CDC Study answers this question

COVID-19 vaccine for lupus patients: One COVID shot effective?
Is just one COVID shot effective?

Please get your COVID-19 vaccine! We all would like life to go back to normal. The unvaccinated will be our major obstacle in reaching that goal. (and yes, that is my, and many others, unapologetic opinion)
QUESTION: How effective is just one COVID Shot if you did not get the second?
ANSWER: 82%

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Lupus Patients Need to Know about a Lupus Nephritis Urine Sample

Lupus Nephritis Urine Samples: What They Tell Us

A lupus nephritis urine sample is important for all SLE patients to give regularly. Click on the video below to learn why it is so important to give a urine sample every 3 months when you have systemic lupus.

You will learn:
– Why getting a lupus nephritis urine sample is important for all systemic lupus patients
– How to properly collect a urine specimen: Systemic lupus patients should give a urine sample every 3 months as per the 2020 EULAR (European Union League Against Rheumatism) guidelines that were developed for the prevention, diagnosis, and treatment of lupus nephritis. Catching a mid-stream clean catch sample is best.
– The symptoms of lupus nephritis 
          Did you know that the most common symptom of early lupus nephritis is no symptoms at all?
– The different kinds of lupus nephritis. We divide them into 5 classes. Classes I and II generally do not need treated. Class VI requires dialysis. There is an unclassed type called “lupus podocytopathy” as well. 
– How it is diagnosed. The kidney biopsy is most important for diagnosis. 
– The importance of diet, exercise, mindfulness. Practicing “The Lupus Secrets” is one of the best things you can do!
– How it is treated
– What happens when it is not treated. Classes III, IV usually result in complete kidney failure and the need for dialysis when not treated. This occurs almost 100% of the time.  Yet, many patients can go into remission with treatment if diagnosed and treated quickly. 
– How to get the most out of virtual online doctor visits. 
– An online support group for people who have lupus nephritis.