Keep biologics going through vaccine doses, a trial suggests

The edition in brief

The edition closes on the COVER trial: 840 people with inflammatory arthritis on TNF inhibitors, IL-17 inhibitors, abatacept or JAK inhibitors were randomised to continue or hold therapy for two weeks after a COVID-19 booster. Holding gave no antibody advantage (ratio 0.96, 95% CI 0.36 to 2.56) but more than doubled the odds of a flare (OR 2.27), most of all on JAK inhibitors. Routine interruption around vaccination looks unjustified. A meta-analysis of eight small trials (535 people) found GLP-1 receptor agonists cut about 6.5 kg in people taking antipsychotics, with more nausea, vomiting and constipation but no excess serious harm; psychiatric safety could not be judged. The VIDEO-KD trial showed a video decision aid plus a patient-recorded statement of wishes raised documented advance care planning in adults over 65 with advanced kidney disease from 40% to 57%. In 21 Veterans Affairs hospitals, 18% of medical inpatients had been medically ready to leave for a week or more, most awaiting long-term care placement. The pearl is a quick anticholinergic burden check on admission.