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RIP to Glucocorticoids in GPA
For many years glucocorticoids were the mainstay of our treatment of granulomatosis with polyangiitis (GPA). The paradigm shifted with cyclophosphamide and then again with rituximab, and we used less steroids, but we still used lots. Avacopan teased the demise of steroids, but in the trial they, and now we, still use them. Glucocorticoids are our old trusty friend, our comfort blanket. But no more! Good riddance to the medication with the highest long-term adverse event burden that we use. Long-term glucocorticoids in GPA should now be a rarity. The reason for such exuberance is the TAPIR study presented by Dr. Peter Merkel at Saturday’s opening plenary session.
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SELECT-GCA: Upa in GCA Merkel Upa 15 mg v 7.5 v PBO w slower GC taper 70% new onset, 30% relapse. Few prev on IL6 Primary endpt: sustained remission at w52- UPA 15 mg beats PBO (p=0.0019) 34% relapse in UPA vs 60% PBO Less steroids, longer time to flare @RheumNow #ACR24 #ACRBest https://t.co/1OV2889Ny0
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#ACR24 Year in Review: 💡GLP1i significantly decreased knee OA pain over time (or was it the wt loss itself?🤨) 💡CD19 CAR T-Cell therapy has potential to treat/cure many autoimmune diseases (are risks and $ worth the benefit?) 💡 High risk of CV events within 30 days of gout… https://t.co/XF63zr6lk4 https://t.co/oRNri66Il9
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