Hey #IBD folks on generic drugs - check out the GI meds at @costplusdrugs (A PBC) - Canasa, mesalamine, esomeprazole available at reasonable prices. Hoping that budesonide and biosimilars (adalimumab, infliximab) are next. Fewer patients driving to Canada? costplusdrugs.com/medications/
Canasa price is better than @GoodRx (which is better than a lot of other options). Also give #GoodRx a look if you are price-shopping on expensive meds
Warning - note that @costplusdrugs does not take insurance - cash pay, out of pocket. This may still work if your copays are high, or you set up an HSA account
HSAs (Health Savings Accounts) are pre-tax accounts that roll over any extra $ to the following year - you can use to pay for meds, but only eligible if you have a high deductible health plan (HDHP). These are increasingly popular among #IBD patients in the US
what is a HDHP? A health insurance plan with an annual deductible of at least $1400 for an individual or $2800 for a family (in 2022, adjusted annually). healthcare.gov/glossary/high-…
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When a new drug is approved in your field, it is a good practice to go through the prescribing information in detail. There is a *lot* to unpack in the #Ozanimod PI. Let's take a tour (THREAD)
First, *before prescribing*, there are 7 required assessments in section 2.1.
1⃣ recent CBC with lymphocyte count
2⃣ recent LFTs
3⃣ EKG to rule out long QT, heart block, sick sinus
4⃣ Eye exam if prior uveitis, macular edema
5⃣ Washout of prior immunosuppressive drugs...
6⃣ Washout of drugs that slow heart rate and/or AV conduction
7⃣ Test patients for antibodies to VZV - vaccinate if negative *before* starting drug
THREAD: This year’s #shotwave tweet is unusual. Not about a flu shot (though I got one back in September). This year I am participating in a randomized, controlled trial with my mom. We are both enrolled in a #COVID-19 vaccine trial. 1/15 @DrsMeena#StandBackImGoingToTryScience
We enrolled on day 1 at our University of Michigan site, in the Michigan Clinical Research Unit (MCRU), where I enroll and see a lot of #IBD patients participating in clinical trials. #IBD patients (on immunosuppression +/- steroids) would not be eligible for this study. 2/15
20K participants will get vaccine, 10K will get salt water (saline) placebo. This is one of 4 vaccines that are likely to be ready in large numbers in January (if they work and are safe) 3/15
This Saturday, May 2nd, will be a little sad for me. I (and about 13,000 of my GI friends) would have been in Chicago for @DDWMeeting. That won't happen. So I decided (with a few friends) to have a get-together. A #TotallyUnofficial "Poster Rounds".
In a webinar format over 1 hour, at 3PM EDT, noon PDT, 8 PM UK time, 9 PM CET, with informal presentations and discussion of 4 posters. We will have two posters that would have been presented at the meeting, and two "late breakers"/works in progress.
Our new IMIBD section vice chair, Fernando Velayos @Realcecum and I will host. @charlie_lees will lead off with a presentation of his new study of #IBD telemedicine across countries, a topic we have all had to become familiar with very rapidly in the Time of #COVID19
Questions today about the risk of coronavirus nCoV-19 in #IBD patients on immunosuppressive therapies. We don't know a lot, as this is quite new. The most up-to-date information can be found at the CDC website cdc.gov/coronavirus/20…
It appears to be spread by respiratory droplets, generally when you inhale droplets from a cough or sneeze from a nearby person (usually within 6 feet). Do #IBD patients have increased risk for this respiratory virus?
By analogy to influenza, another respiratory virus spread by droplets that we know more about, #IBD patients have about a 50% increased risk of influenza. This risk goes up by about 20% more if you are on steroids. ncbi.nlm.nih.gov/pubmed/30020478