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Vincent Rajkumar Profile picture
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28 Mar, 5 tweets, 1 min read
Cause and Effect? Maybe. ImageImage
It's a race:

Vaccines vs Variants
Vaccination vs Vaccine Hesitancy
Patients vs Premature opening
Masks and Distancing = Work, but unsustainable long term

Vaccines = Work, and easily sustainable.

Hard work of making effective vaccines is over. Boosters will be easier. #GetVaccinated
*Meant Patience. Not Patients.
Sorry for typo.

But opening prematurely means we are putting people at risk of becoming patients.
*Meant Patience. Not Patients.
Sorry for typo.

But opening prematurely means we are putting people at risk of becoming patients.

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More from @VincentRK

Vincent Rajkumar Profile picture
30 Mar
Why do you often get confusing and contradictory messages from experts?

Why does medical expert opinion sometimes seem incorrect, outdated, or even contrary to the evidence?

1/ Medicine is really complicated. No one is truly an expert except in a tiny segment of it, at best.
2/ When a car doesn't work a good mechanic knows what each part does. To know what's wrong. Doesn't need a randomized trial to know how to fix it.

Our body is not like a car. We don't know a fraction of how it works and what each part does. Human biology is still in its infancy
3/ Medicine moves at speed of light. Keeping up to date is no small task. Even if you read all the latest information as they come in, you may have time to scan the headlines or abstract—
Not critically review it.
Read 12 tweets
Vincent Rajkumar Profile picture
29 Mar
There may be a 4th wave in COVID cases, but I don't think there will be another significant wave in deaths. Ripple maybe. Not a wave.

We are doing very well in vaccinations. The vaccines work. There is reason to be optimistic. ImageImage
I'd rather that deaths not be at the level of 1000 per day. It's really high and I would like to seen it come down drastically.

I'm confident if we keep vaccinating the way we have been, this will happen. Sooner rather than later.
All of the cases I have heard of in fully vaccinated people have been mild or asymptomatic.
Read 7 tweets
Vincent Rajkumar Profile picture
29 Mar
When we say "Vaccine Passport" some people may have negative reactions. I'd rather call it proof of vaccination.

The reality is that air travel and big gatherings in most places are likely to require proof of vaccination or a negative test. Of the two, I'd go with the vaccine.
Remember, your own friends and family may have small gatherings, and without being explicit they may only invite people who they know are vaccinated. Just for your own safety and theirs.

I strongly believe vaccines are they way to get us to normal, and soon.
As someone lucky to have been vaccinated, I can tell you the peace of mind is incredible.
Read 4 tweets
Vincent Rajkumar Profile picture
29 Mar
Just out: Double blind placebo controlled randomized trial of oral triplet Ixazomib-Rd vs Rd as frontline therapy of multiple myeloma. Helps elderly patients unable to travel.

Personally gratifying as 11th randomized trial as a lead investigator. ashpublications.org/blood/article-… Image
Ixazomib is an oral proteasome inhibitor that is given once a week.

One pill once a week is a convenient way of delivering proteasome inhibitor therapy that otherwise takes a trip to the clinic.
CR and VGOR rates were higher with ixazomib-Rd vs placebo-Rd.

Median PFS: 35.3 months with ixazomib Rd vs 21.8 months with placebo-Rd, P = 0.073.
Read 6 tweets
Vincent Rajkumar Profile picture
27 Mar
As Congress announces it will look into the price of insulin, here are slides from a talk I gave in 2018 on the problem. #Insulin4All @RepKatiePorter

Prepare to be shocked.
If you would rather read the paper. Here it is in @MayoProceedings published Jan 1, 2020. I've summarized the problem. mayoclinicproceedings.org/article/S0025-…
Or you can watch or listen to my lecture. Insulin an Beyond.
Read 5 tweets
Vincent Rajkumar Profile picture
27 Mar
Breaking News: lde-cel (Abecma; idecabtagene vicleucel), approved by FDA for multiple myeloma.

This is the first CAR-T therapy for myeloma. Many patients have been waiting for this good news. @agarwalonc @BMS_Myeloma_US @bluebirdbio news.bms.com/news/corporate…
Here is the data that led to the FDA approval published in @NEJM

73% response rate; 33% CR rate; 26% MRD-
Median PFS 9 months

Congrats everyone. Nikhil Munshi, @ldandersonjr @ninashah33 @DMadduri @BerdejaJesus @SagarLonialMD @NoopurRajeMD @YiLinMDPhD nejm.org/doi/full/10.10…
Side effects: Milder in my experience than approved lymphoma CAR-Ts. Grade 3 or higher cytokine release syndrome (CRS) in 5% of patients. Grade 3 neurotoxic effects in 3%.

Overall well tolerated.
Read 5 tweets

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