#dermJC Transcript
Healthcare social media transcript of the #dermJC hashtag.
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See #dermJC Influencers/Analytics.
| Profile | Tweet |
|---|---|
 | Dermatology Journal Club @DermatologyJC Hello everyone! Please introduce yourself and state any COI. Make sure you use #dermjc so people can follow along. A big welcome to our @HOJournalClub colleagues! |
 | Todd McCarty 💊🐉👨⚕️ @TMcCarty2010 RT @HOJournalClub: We're kicking off 2020 #hojournalclub by partnering with our @IDJClub partners to discuss this provocative paper (link below)! Join us in T minus 10 mins! #dermjc |
 | Roxana Daneshjou MD/PhD @RoxanaDaneshjou @DermatologyJC @HOJournalClub Hi this is Roxana, #dermatology resident at Stanford. #dermjc #hojournalclub |
 | Liza Henry McDonald @DocLHenry @DermatologyJC @HOJournalClub Hi this is Liza, a GU medical oncologist in Chicago. I'm excited for tonight's chat! #dermjc #hojournalclub |
 | Jonathan Berry @jlberrymd Hi all, I'm Jonathan, an IM resident and future HO fellow tweeting from Boston. Excited for tonights combo chat! #dermjc #hojournalclub |
| Todd McCarty 💊🐉👨⚕️ @TMcCarty2010 @DermatologyJC @HOJournalClub Todd McCarty, ID faculty @UABSOM no COI #dermjc |
| Todd McCarty 💊🐉👨⚕️ @TMcCarty2010 RT @DermatologyJC: Hello everyone! Please introduce yourself and state any COI. Make sure you use #dermjc so people can follow along. A big welcome to our @HOJournalClub colleagues! |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou @DermatologyJC @HOJournalClub I consult for Enspectra health, unrelated to this topic. #dermjc |
 | HOJournalClub @HOJournalClub Welcome everyone! Follow along! #dermjc #hojournalclub |
| Dermatology Journal Club @DermatologyJC Let's begin! #dermjc Our paper once again is here @JAMAOnc: https://t.co/JTYU1mgnAr |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou RT @DermatologyJC: Hello everyone! Please introduce yourself and state any COI. Make sure you use #dermjc so people can follow along. A big welcome to our @HOJournalClub colleagues! |
 | JAMA Oncology @JAMAOnc RT @DermatologyJC: Let's begin! #dermjc Our paper once again is here @JAMAOnc: Let's begin! #dermjc Our paper once again is here @JAMAOnc: https://t.co/JTYU1mgnAr |
 | JAMA Dermatology @JAMADerm RT @DermatologyJC: Let's begin! #dermjc Our paper once again is here @JAMAOnc: Let's begin! #dermjc Our paper once again is here @JAMAOnc: https://t.co/JTYU1mgnAr |
| Dermatology Journal Club @DermatologyJC Q1: There have been a few small studies now talking about immune checkpoint inhibitor response and antibiotic use. What are your thoughts on the issue? #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou @TMcCarty2010 @DermatologyJC @HOJournalClub @UABSOM Haha @DrJohnBarbieri has also written a lot about antibiotic stewardship in dermatology! #dermjc |
 | UAB Hematology/Oncology Fellowship @UABHemOncFellow RT @HOJournalClub: We're kicking off 2020 #hojournalclub by partnering with our @IDJClub partners to discuss this provocative paper (link below)! Join us in T minus 10 mins! #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou RT @DermatologyJC: Q1: Q1: There have been a few small studies now talking about immune checkpoint inhibitor response and antibiotic use. What are your thoughts on the issue? #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou RT @HOJournalClub: Welcome everyone! Follow along! #dermjc #hojournalclub |
 | chessdoc @Sunilrang @HOJournalClub Hi everyone! Sunil Rangarajan, oncology fellow from UAB #dermjc |
| HOJournalClub @HOJournalClub #dermjc #hojournalclub |
 | John Barbieri, MD, MBA @DrJohnBarbieri Interesting to see that PRIOR antibiotics were associated with worse treatment response. Suggests that antibiotic induced changes to the microbiome can be persistent, which has implications for many clinical scenarios #dermjc |
| Todd McCarty 💊🐉👨⚕️ @TMcCarty2010 @DermatologyJC The immune system is a complex and fascinating thing. Have to wonder about the impact of antibiotics on the microbiome and resultant alteration of immune modulation. Way outside my realm of expertise. Going from association to mechanism will be complex/difficult. #dermjc |
| John Barbieri, MD, MBA @DrJohnBarbieri John Barbieri from @Penn No COI #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou @DermatologyJC Here is another small study. #dermjc https://t.co/1vCAwZB5vm |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou @DermatologyJC I’ve wondered about confounders... is there something else about people who end up needing antibiotics which may make their outcomes worse? Are they sicker or have more comorbidities beyond what was controlled for? #dermjc |
| HOJournalClub @HOJournalClub @DermatologyJC It's certainly provocative. In onc we know we're just scratching the surface of understanding all the mechanisms at work. Though I struggle with how we get to a place of really trading it this specific interplay. #dermjc #hojournalclub |
| Jonathan Berry @jlberrymd A1 It seems like there are so many possible confounders in patients who have antibiotic use. They addressed this somewhat but not enough for me to know what to do with the correlation link #dermjc |
| John Barbieri, MD, MBA @DrJohnBarbieri @RoxanaDaneshjou @DermatologyJC I worry about that, maybe those with worse immune systems get infections (thus AtBx) and have poorer response to ICI #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou @DermatologyJC Each study that has found this association has been small. And to my knowledge (could be wrong), a causal relationship between antibiotic use and immune checkpoint inhibitor failure hasn’t been established. #dermjc |
| Dermatology Journal Club @DermatologyJC #dermjc |
| Dermatology Journal Club @DermatologyJC RT @DrJohnBarbieri: @RoxanaDaneshjou @DermatologyJC I worry about that, maybe those with worse immune systems get infections (thus AtBx) and have poorer response to ICI #dermjc |
| Dermatology Journal Club @DermatologyJC RT @RoxanaDaneshjou: @DermatologyJC Each study that has found this association has been small. And to my knowledge (could be wrong), a causal relationship between antibiotic use and immune checkpoint inhibitor failure hasn’t been established. #dermjc |
| Todd McCarty 💊🐉👨⚕️ @TMcCarty2010 @DrJohnBarbieri @RoxanaDaneshjou @DermatologyJC Certainly plausible that plays a role, but that also uses the assumption that the antibiotics were appropriate/needed, which we know a large portion are not. #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou Q2: Have you or do you plan to change your management in any way for patients on immune checkpoint inhibitors? #dermjc |
| Dermatology Journal Club @DermatologyJC RT @TMcCarty2010: @DrJohnBarbieri @RoxanaDaneshjou @DermatologyJC Certainly plausible that plays a role, but that also uses the assumption that the antibiotics were appropriate/needed, which we know a large portion are not. #dermjc |
| Jonathan Berry @jlberrymd A2 I'm not sure how this would change management. Data is associative, but if anything, certainly doesn't suggest harm from ABx while pts are already on checkpoint inhibitors #dermjc #HOJournalclub |
| Dermatology Journal Club @DermatologyJC RT @RoxanaDaneshjou: Q2: Q2: Have you or do you plan to change your management in any way for patients on immune checkpoint inhibitors? #dermjc |
| Dermatology Journal Club @DermatologyJC Sorry, accidentally scheduled Q2 from my personal account! #dermjc |
| John Barbieri, MD, MBA @DrJohnBarbieri @RoxanaDaneshjou I don’t think it should change practice. Patients who need antibiotics need them. We should be judicious with their use either way. For me study is most interesting from a hypothesis generating standpoint. #dermjc |
| Dermatology Journal Club @DermatologyJC RT @DrJohnBarbieri: @RoxanaDaneshjou I don’t think it should change practice. Patients who need antibiotics need them. We should be judicious with their use either way. For me study is most interesting from a hypothesis generating standpoint. #dermjc |
| Dermatology Journal Club @DermatologyJC RT @jlberrymd: A2 I'm not sure how this would change management. Data is associative, but if anything, certainly doesn't suggest harm from ABx while pts are already on checkpoint inhibitors #dermjc #HOJournalclub |
| Liza Henry McDonald @DocLHenry @DermatologyJC It's certainly provocative. In onc we know we're just scratching the surface of understanding all the mechanisms at work. Though I struggle with how we get to a place of really understanding this specific interplay. So many confounders. #dermjc #hojournalclub |
| Dermatology Journal Club @DermatologyJC #dermjc |
| Dermatology Journal Club @DermatologyJC RT @DocLHenry: @DermatologyJC It's certainly provocative. In onc we know we're just scratching the surface of understanding all the mechanisms at work. Though I struggle with how we get to a place of really understanding this specific interplay. So many confounders. #dermjc #hojournalclub |
| HOJournalClub @HOJournalClub RT @DrJohnBarbieri: @RoxanaDaneshjou I don’t think it should change practice. Patients who need antibiotics need them. We should be judicious with their use either way. For me study is most interesting from a hypothesis generating standpoint. #dermjc |
| John Barbieri, MD, MBA @DrJohnBarbieri @RoxanaDaneshjou 1. Do alterations of microbiome (by AtBx) correlate with response to ICI. 2. Are there treatments directed at improving microbiome that could improve response to ICI #dermjc |
| chessdoc @Sunilrang @DermatologyJC While the ICIs cause fairly non specific immune activation, since there was a prior clone expansion targeted against a pathogen, may be the cancer cells are not targeted well enough #dermjc @hemoncjc |
 | Steven Chen 陳持威, MD, MPH, MHPEd @DrStevenTChen #dermjc sorry to be joining late! Steven from Boston, no COI (except that skin irAE from ICI is my research interest, so super excited about this topic!) #dermtwitter |
| Liza Henry McDonald @DocLHenry @DrJohnBarbieri @RoxanaDaneshjou I've seen probiotics mentioned in this regard. #dermjc #hojournalclub |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou @DrJohnBarbieri I feel like our threshold to start antibiotics on cancer patients is lower and maybe shouldn’t be. Also maybe we should avoid antibiotics for acne in this population? Thoughts @DrJohnBarbieri? #dermjc |
| Steven Chen 陳持威, MD, MPH, MHPEd @DrStevenTChen @RoxanaDaneshjou #dermjc I think it isn't going to make huge differences. However, one very pertinent place is that I do think twice before starting things like doxy for BP or flagyl for lichenoid rash and will double check with onc (much like I do before starting immunosuppressants). |
| HOJournalClub @HOJournalClub Interesting point! #dermjc #hojournalclub |
| Dermatology Journal Club @DermatologyJC RT @Sunilrang: @DermatologyJC While the ICIs cause fairly non specific immune activation, since there was a prior clone expansion targeted against a pathogen, may be the cancer cells are not targeted well enough #dermjc @hemoncjc |
| HOJournalClub @HOJournalClub RT @RoxanaDaneshjou: @DrJohnBarbieri I feel like our threshold to start antibiotics on cancer patients is lower and maybe shouldn’t be. Also maybe we should avoid antibiotics for acne in this population? Thoughts @DrJohnBarbieri? #dermjc |
| Dermatology Journal Club @DermatologyJC RT @DrJohnBarbieri: @RoxanaDaneshjou 1. Do alterations of microbiome (by AtBx) correlate with response to ICI. 2. Are there treatments directed at improving microbiome that could improve response to ICI #dermjc |
| Dermatology Journal Club @DermatologyJC RT @DrStevenTChen: #dermjc sorry to be joining late! Steven from Boston, no COI (except that skin irAE from ICI is my research interest, so super excited about this topic!) #dermtwitter |
| Dermatology Journal Club @DermatologyJC RT @DocLHenry: @DrJohnBarbieri @RoxanaDaneshjou I've seen probiotics mentioned in this regard. #dermjc #hojournalclub |
| Dermatology Journal Club @DermatologyJC RT @RoxanaDaneshjou: @DrJohnBarbieri I feel like our threshold to start antibiotics on cancer patients is lower and maybe shouldn’t be. Also maybe we should avoid antibiotics for acne in this population? Thoughts @DrJohnBarbieri? #dermjc |
| Dermatology Journal Club @DermatologyJC RT @DrStevenTChen: @RoxanaDaneshjou #dermjc I think it isn't going to make huge differences. However, one very pertinent place is that I do think twice before starting things like doxy for BP or flagyl for lichenoid rash and will double check with onc (much like I do before starting immunosuppressants). |
| chessdoc @Sunilrang @DevikaDasMD @DermatologyJC It is interesting how most patients included in the mentioned studies are lung cancer patients. #dermjc @HOJournalClub |
| Dermatology Journal Club @DermatologyJC RT @Sunilrang: @DevikaDasMD @DermatologyJC It is interesting how most patients included in the mentioned studies are lung cancer patients. #dermjc @HOJournalClub |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou @DrJohnBarbieri I think I am probably biased on the overlap between acne and cancer populations. Lots of younger cancer patients at our center. #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou Q3: What further studies would you like to see with regards to ICI response and antibiotic use? #dermjc |
| John Barbieri, MD, MBA @DrJohnBarbieri @DevikaDasMD @DermatologyJC Yes, I think the implications for future microbiome research are a major takeaway from this study #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou @Sunilrang @DevikaDasMD @DermatologyJC @HOJournalClub It is interesting! Also as a dermatologist I think about this since advanced melanoma patients are now also getting immune checkpoint inhibitors... #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou @ADesaiMD @TMcCarty2010 @DrJohnBarbieri @DermatologyJC Make sure to use #dermjc so people can track your responses through the hashtag! |
| Dermatology Journal Club @DermatologyJC #dermjc |
| Jonathan Berry @jlberrymd A3 At the least I would like to see more controlling for confounders. An RCT isn't really an option for this case, but perhaps a prospective cohort study might be? #dermjc #HOJournalclub |
| Liza Henry McDonald @DocLHenry @RoxanaDaneshjou @DrJohnBarbieri Interesting perspective. I would say most of the ICI use is currently in malignancies that track in older populations. But they're moving into so many settings that this will likely shift more over time. #dermjc #hojournalclub |
| HOJournalClub @HOJournalClub #dermjc #hojournalclub |
| Dermatology Journal Club @DermatologyJC RT @DocLHenry: @RoxanaDaneshjou @DrJohnBarbieri Interesting perspective. I would say most of the ICI use is currently in malignancies that track in older populations. But they're moving into so many settings that this will likely shift more over time. #dermjc #hojournalclub |
| Dermatology Journal Club @DermatologyJC RT @jlberrymd: A3 At the least I would like to see more controlling for confounders. An RCT isn't really an option for this case, but perhaps a prospective cohort study might be? #dermjc #HOJournalclub |
| Liza Henry McDonald @DocLHenry @ADesaiMD @TMcCarty2010 @DrJohnBarbieri @RoxanaDaneshjou @DermatologyJC I would wonder why the impact is seen with pre-abx but not concurrent abx? #dermjc #hojournalclub |
| HOJournalClub @HOJournalClub #dermjc #hojournalclub |
| chessdoc @Sunilrang @RoxanaDaneshjou @DevikaDasMD @DermatologyJC @HOJournalClub Probably the selection bias is due to the time when the patients were included when ICI wasn’t that widely used in other cancers (2015-2018). Does give directions for exploring mechanisms #dermjc |
| Steven Chen 陳持威, MD, MPH, MHPEd @DrStevenTChen A3: Given how ICIs likely are lowering tolerance and increasing immunologic phenomenon, I think a study looking at the ICI patients who then react to multiple abx (across classes) would be interesting. #dermjc |
| Liza Henry McDonald @DocLHenry @DrStevenTChen @DermatologyJC @RoxanaDaneshjou We're always into a quick check in about our patients to make sure everyone's on the same page! 👍🏻 #dermjc #hojournalclub |
| John Barbieri, MD, MBA @DrJohnBarbieri @DocLHenry @ADesaiMD @TMcCarty2010 @RoxanaDaneshjou @DermatologyJC Possibly pre-AtBx disrupt microbiome prior to ICI start whereas concurrent AtBx don’t impact microbiome until effects from ICI have already started #dermjc #hojournalclub |
| Steven Chen 陳持威, MD, MPH, MHPEd @DrStevenTChen Specifically speaking, I've now seen patients who get a pretty severe toxicity seemingly triggered by different meds (not just abx, but abx seem to be one of the biggest triggers). Trying to predict or better manage these patients would be a nice goal to shoot for. #dermjc |
| John Barbieri, MD, MBA @DrJohnBarbieri @DocLHenry @ADesaiMD @TMcCarty2010 @RoxanaDaneshjou @DermatologyJC Pre-AtBx might also be more strongly associated with poor health status/immune function as a potential confounded #dermjc #hojournalclub |
| Liza Henry McDonald @DocLHenry @DevikaDasMD @DermatologyJC @DrJohnBarbieri @IDJClub Taking this one step further--is the effect same in cancers involving different microbiomes? Bladder? Colon? @IDJClub #dermjc #hojournalclub |
| chessdoc @Sunilrang @HOJournalClub Sorry. Forgot to mention.. COI - one of my research interests is ICI induced acute kidney injury. Co-author of a multi center study who recently published on this topic.. #dermjc |
| HOJournalClub @HOJournalClub RT @jlberrymd: A3 At the least I would like to see more controlling for confounders. An RCT isn't really an option for this case, but perhaps a prospective cohort study might be? #dermjc #HOJournalclub |
| Dermatology Journal Club @DermatologyJC RT @DrJohnBarbieri: @DevikaDasMD @DermatologyJC Yes, I think the implications for future microbiome research are a major takeaway from this study #dermjc |
| John Barbieri, MD, MBA @DrJohnBarbieri @DocLHenry @DevikaDasMD @DermatologyJC @IDJClub A lot of interesting questions for future study! #dermjc #hojournalclub |
| Dermatology Journal Club @DermatologyJC RT @DocLHenry: @DevikaDasMD @DermatologyJC @DrJohnBarbieri @IDJClub Taking this one step further--is the effect same in cancers involving different microbiomes? Bladder? Colon? @IDJClub #dermjc #hojournalclub |
| Dermatology Journal Club @DermatologyJC @Sunilrang @HOJournalClub Share a link to the study! #dermjc |
| HOJournalClub @HOJournalClub #dermjc #hojournalclub |
| chessdoc @Sunilrang @DevikaDasMD @DermatologyJC @DrJohnBarbieri @IDJClub Amazing paper!! #dermjc |
| HOJournalClub @HOJournalClub RT @RoxanaDaneshjou: Q2: Q2: Have you or do you plan to change your management in any way for patients on immune checkpoint inhibitors? #dermjc |
| Dermatology Journal Club @DermatologyJC Q4: Final thoughts? Lingering questions? #dermjc |
| Todd McCarty 💊🐉👨⚕️ @TMcCarty2010 @DermatologyJC Outpatient duration of abx is a very difficult frontier for antimicrobial stewardship programs to tap into. Wonder if some of the presumed modulation could be minimized with shorter durations. #dermjc |
| Dermatology Journal Club @DermatologyJC RT @TMcCarty2010: @DermatologyJC Outpatient duration of abx is a very difficult frontier for antimicrobial stewardship programs to tap into. Wonder if some of the presumed modulation could be minimized with shorter durations. #dermjc |
| Dermatology Journal Club @DermatologyJC Also thank you to @HOJournalClub for coordinating with us and for everyone’s participation!! Feel free to keep discussing! #dermjc |
| John Barbieri, MD, MBA @DrJohnBarbieri @TMcCarty2010 @DermatologyJC However, even relatively short (for dermatologists) durations of antibiotics can result in notable changes to microbiome. I often think treating fewer patients may be more important to using shorter courses. #dermjc https://t.co/mYm2tZndJe |
| John Barbieri, MD, MBA @DrJohnBarbieri RT @DermatologyJC: Also thank you to @HOJournalClub for coordinating with us and for everyone’s participation!! Feel free to keep discussing! #dermjc |
| Liza Henry McDonald @DocLHenry @DermatologyJC Another interesting step towards understanding the interplay b/t microbiome and immune recognition/cancer control. Needs much more investigation but will give me pause when gearing up for ICI Rx for my pts. #dermjc #hojournalclub |
| Todd McCarty 💊🐉👨⚕️ @TMcCarty2010 @DrJohnBarbieri @DermatologyJC We know from inpatient data that a single day of antibiotics (anti-pseudomonals in particular) have an impact on the potential for abx resistance, hard not to imagine similarly fast impact on microbiome. #dermjc |
| Steven Chen 陳持威, MD, MPH, MHPEd @DrStevenTChen @DermatologyJC My take away - Using abx is very different than abx for inflammatory conditions (like we use in #dermatology). We can definitely find other options (hopefully non-immunosuppressive ones) in derm for non-infectious issues. #dermjc |
| HOJournalClub @HOJournalClub Thanks for the interesting discussion and new colleagues! #dermjc #hojournalclub |
| Dermatology Journal Club @DermatologyJC RT @HOJournalClub: Thanks for the interesting discussion and new colleagues! #dermjc #hojournalclub |
| Dermatology Journal Club @DermatologyJC RT @DrStevenTChen: @DermatologyJC My take away - Using abx is very different than abx for inflammatory conditions (like we use in #dermatology). We can definitely find other options (hopefully non-immunosuppressive ones) in derm for non-infectious issues. #dermjc |
| Dermatology Journal Club @DermatologyJC RT @TMcCarty2010: @DrJohnBarbieri @DermatologyJC We know from inpatient data that a single day of antibiotics (anti-pseudomonals in particular) have an impact on the potential for abx resistance, hard not to imagine similarly fast impact on microbiome. #dermjc |
| Dermatology Journal Club @DermatologyJC RT @DocLHenry: @DermatologyJC Another interesting step towards understanding the interplay b/t microbiome and immune recognition/cancer control. Needs much more investigation but will give me pause when gearing up for ICI Rx for my pts. #dermjc #hojournalclub |
 | Leo Shmuylovich, MD PhD @leoshmu At pre-interview dinner today and had to miss #dermjc, but got to hear a great joke from an applicant (they often have them prepared since apparently that is a common question on the trail): 1/ |
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