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Achilles,ankle,heel

Steroid Injection for Chronic Achilles Tendinopathy

MedPage Today

Adding a corticosteroid shot to exercise therapy significantly improved symptoms of chronic Achilles tendinopathy, a 100-person randomized trial found.

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2021,year

ICYMI: 2021 Rheumatology Year in Review

Jack Cush, MD

For 2022, let's look our top 10 list of advances, game-changers, worries and those better medical practices that evolved during 2021.

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virus,injection,COVID,vaccine

Two Week Methotrexate Hold with COVID-19 Vaccination

Jack Cush, MD

A cohort study of rheumatoid arthritis (RA) patients evaluated immunogenicity of COVID vaccination with and without holding methotrexate (MTX) for and 2-weeks and showed better immunogenicity, but more RA flares with the second MTX withdrawal. 

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JAK Janus

JAK/STAT pathway in pyoderma gangrenosum: a new therapeutic highway?

Aurelie Najm, MD, PhD

Pyoderma gangrenosum (PG) is rare, but often associated with different forms of arthritis, in particular rheumatoid arthritis and inflammatory bowel diseases. 

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EULAR,poster

EULAR 2022 – Day 3 Report

Jack Cush, MD

By now, those of us attending the meeting know how to find a free coffee or sprite, have found comfortable meeting nooks and know our way around! PAnd congrats to you virtual Rheums for mastering the multi-screen, multitask simultaneous consumption posters, tweets and oral abstract presentations.

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woman-1284353_640.jpg

Babies! Safety and Outcomes Data on Pregnancies

Kathryn H. Dao, M.D.

EULAR Congress 2022 highlighted several posters on pregnancy, an important subject as most rheumatic diseases afflicts women during their childbearing years.

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GLORIA Study Pred vs PBO in >65yrs RA x 2 years. 451 Pts & DAS28 4.5. 79% on DMARDs (14% biologics) Upside: Lower DAS28 -0.37 & less Xray progression -1.7 Sharp units Downside: 24% more AE (mild infxns), signif.small lowering of lumbar BMD -1% You Decide https://t.co/RRq0WcFsXz https://t.co/xLxjPPSMhh

Links:

Dr. John Cush RheumNow ( View Tweet)
EULAR recommendations for management of #RheumatoidArthritis 6️⃣Glucocorticoids should be tapered & discontinued as soon as clinically feasible 8️⃣JAKi can be used but consider risk factors via Prof Smolen #EULAR2022 https://t.co/7cocPSpgkH
Dr Ai Lyn Tan DrAiLynTan ( View Tweet)
Positive study NUT when to use the Rx? PMR RCTof 1 g #rituximab once. Over 1 yr with more steroid free remission - curves separate by 21 weeks (steroids off) POS0269 @RheumNow @eular_org #EULAR2023 when to use it-COVID risk, ?prefer IL6i

Janet Pope Janetbirdope ( View Tweet)

#LB0006 #EULAR2022 Therapy for relapsing polymyalgia rheumatica. 118/280 recruited re:COVID impact. Phase 3 RCT of Sarilumab+14Wk Steroid taper showed more pts had sustained remission at Wk52 vs PBO+52Wk Steroid Taper(28% vs 10%) even if CRP excluded. PRO improved too! @RheumNow https://t.co/P11iXIAfGn
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
SAPHYR phase 3 RDBPCT study: #sarilumab vs PCB for relapsing #PMR on pred 7.5+ mg/d. Study met endpoints (whether of or not CRP was included). Time to first flare was longer w/SARI, less steroid use, and also better PROs. AE: #EULAR2022 LB0006 @rheumnow 1/2 https://t.co/lIspLKlveb
TheDaoIndex KDAO2011 ( View Tweet)
Novel ePROMS use. Use of ePROMS RAPID3/PASS and asking patients if they had a flare had high diagnostic accuracy identifying those not needing DMARD or steroid intensification up and eligible to skip their next outpatient clinic visit. Seppen et al #EULAR2022 @RheumNow POS0381

Dr. Antoni Chan synovialjoints ( View Tweet)

Palmowski et al. Glucocorticoids and bone density in GCA/PMR/other vasculitis from Rh-GIOP. Weird one, no increase in osteoporosis, no association with current or cumulative steroid dose and osteoporosis. Low BMI, vert #, PPIs were assoc osteoporosis. @RheumNow #EULAR2022 POS1139 https://t.co/n3d6YArXmU
Richard Conway RichardPAConway ( View Tweet)
More from GLORIA. Tapering pred 5mg after 2 years. Some minor increase in disease activity (DAS28 0.26) with no evidence of adrenal insufficiency. Can successfully withdraw long term steroids! @RheumNow #EULAR2022 OP0270 https://t.co/IV9iJLY22v https://t.co/ZXdwxlXorK

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Richard Conway RichardPAConway ( View Tweet)
In case there was doubt: - steroid toxicity is real in GCA - giving steroid-sparing therapies (TCZ, MTX) early makes a difference just something to not forget when your next new GCA patient rolls in the door? POS0805 #EULAR2022 @RheumNow https://t.co/2wGV3M8wZD
David Liew drdavidliew ( View Tweet)
Boers et al. GLORIA trial of long term 5mg pred in RA. Titled as "favourable balance of benefit and harm". I cannot agree. 24% increase adverse events, NNH 9, for DAS28 0.37 better at 1 year, and really no difference after that. @RheumNow #EULAR2022 OP0263 https://t.co/eO4f1CjH5q https://t.co/VyyZm1QvYy

Links:

Richard Conway RichardPAConway ( View Tweet)
Long-term low-dose steroids for RA: can it be weaned? Weaning after 2y of blinded add-on in RA: either PNL 5mg/d or placebo No substantial evidence of adrenal insufficiency - symptoms same - cortisol/ACTH same It's never too late to wean the pred! OP0270 #EULAR2022 @RheumNow https://t.co/jp2ZOlAEnb
David Liew drdavidliew ( View Tweet)
Yoshimura et al. 10 year findings of TOMORROW study. Glucocorticoid use of even 2mg/day is fracture risk in RA! @RheumNow #EULAR2022 POS0631 https://t.co/c8uCdPzUiE
Richard Conway RichardPAConway ( View Tweet)
Unizony et al. Case series of tocilizumab + 8 weeks steroid in GCA. 30 patients, 50% new 50% relapsing. 77% in sustained remission at week 52! No vision loss. Exciting, needs an RCT @RheumNow #EULAR2022 OP0185 https://t.co/ohBYIWYxBC https://t.co/fsn4x17Hwv

Links:

Richard Conway RichardPAConway ( View Tweet)
#Behcets. If topical oracort / steroids don’t work for Mucosal ulcers consider topical #tacrolimus https://t.co/7ZiLfdwZoP

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Janet Pope Janetbirdope ( View Tweet)

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