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Ten-Year Analysis of Low-Dose Glucocorticoids in early RA
Abstract #1998 by C. Roubille et al from Montpellier, France is a 10-year prospective analysis that looked at the risk of severe outcomes related to very low-dose glucocorticoid in early rheumatoid arthritis from the ESPOIR cohort.
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Immune Necrotizing Myopathy
A full read review of immune-mediated necrotizing myopathy is portrayed as a distinct subtype of inflammatory myopathies first described in 2004.
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Clinical Trial Boom or Bust in Severe COVID-19
A number of recently published clinical trials are further defining the efficacy and outcomes of tocilizumab or remdesivir in treating SARs-CoV-2 infection.
Remdesivir
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Biologics Beneficial in Eosinophilic Vasculitis
Two biologic therapies showed promise in the treatment of refractory or relapsing eosinophilic granulomatosis with polyangiitis (EGPA) in a retrospective European study.
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Mortality in Low Dose Prednisone by Dr. Eric Dein ( @ejdein1). #ACR20
https://t.co/y6dL9V6iDC https://t.co/e7119ymgiq
Links:
Dr. John Cush RheumNow ( View Tweet)
Read our news article "Ten-Year Analysis of Low-Dose Glucocorticoids in early RA" by Meral K. El Ramahi ( @MeralElRamahiMD) #ACR20.
https://t.co/S9rOHc0864 https://t.co/6X4owP6pF0
Links:
Dr. John Cush RheumNow ( View Tweet)
Quick Read! Mortality in Low Dose Prednisone by Dr. Eric Dein ( @ejdein1). #ACR20
https://t.co/y6dL9V6iDC https://t.co/ZFpxoTH07p
Links:
Dr. John Cush RheumNow ( View Tweet)
Dr P Seo notes based on PEXIVAS study while PLEX does not seem to help with AAV, it showed you can drop steroid dose sooner: start pred 1 mg/kg/d but drop down after 1 week to 0.5 mg/kg/d #ACRReview #ACR20 @rheumnow
k dao KDAO2011 ( View Tweet)
Low-dose steroids in RA: what's the harm, right?
(You probably know where I'm going with this)
ESPOIR 10y data: total events, and severe infections worse with dose and time
(cumulative 8.4g ≡ 5mg/d)
No doubt some residual confounding, but real risk!
#ACR20 ABST1998 @RheumNow https://t.co/BAQmOR1ped
David Liew drdavidliew ( View Tweet)
What would you use next? sero+ RA new keratitis requiring prednisone and now also 20 SJC. New rheumatoid nodules. Pt has been on triple csDMARDs + Leflunomide, then 2 JAKi and 2 TNFi also with MTX each time. All Rx works for 6 months then relapse. @RheumNow @CRASCRRheum https://t.co/9cTS1tNE42
Janet Pope Janetbirdope ( View Tweet)
Summary of #ACR20 part B:
- The future is bright with many trainees producing great research per Dr. Diane Karen
- Belimumab (phase III) reduced proteinuria, improved renal for, and helped w/ tapering of GC in pts w/ lupus nephritis but more infect in GC group @RheumNow
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
2020 #ACR20 RA guidelines were against steroid usage in RA. ESPOIR French cohort: 10 years of very low dose GC show increase events (death/CVD/fracture/severe ifn) even on low doses. HR increases every year. Cum GC dose-effect esp ifn, CVD. @RheumNow #ACRBest https://t.co/7b7chCPRxm
Eric Dein ejdein1 ( View Tweet)
When you give IA steroids for knee OA how long do you tell pts it will work for @RheumNow #ACR20 @CRASCRRheum abstr#1650
Janet Pope Janetbirdope ( View Tweet)
Intra-articulations steroids for the knee OA- finding benefits again! IA steroids were good then villified in press with accelerated cartilage loss. Pendulum swings back in abstr#1649 where quadriceps & gait improve post injection @RheumNow #ACR20 @CRASCRRheum #ACRbest https://t.co/0bRsiEKsW4
Janet Pope Janetbirdope ( View Tweet)
Study of Chinese pts on long-term GCs by Dr CC Mok: DEN >> ALN in ⬆spinal BMD & suppressing bone turnover markers after 1yr tx.
No sig. diff in AEs among grps.
Limits: Open-label,small ss,short tx dur'n, not powered for fractures @RheumNow #ACR20 abs1442 https://t.co/m8mT0hMPN8
sheila RHEUMarampa ( View Tweet)
Dr. M. “Peggy” Crow’s #StateofArt lecture at #ACR20 reminds us that HCQ is the foundation of tx, to keep prednisone goal < 7.5mg/d, and that BEL works best in early dz (< 2 yrs) Summary slide provided. https://t.co/3LbWqwwOsr
Dr. Rachel Tate uptoTate ( View Tweet)
Ground-breaking news... the end of #glucocorticoid use in #AAV?
very exciting to reduce GC toxicity! https://t.co/43eCofpOIX
KenWarringtonMD MdWarrington ( View Tweet)
#ACR20 year in review by @JYazdanyMD latest data PEXIVAS and SEMIRA trials on corticosteroids - would you change your clinical practice to minimize even low dose Corticosteroids in RA and Vasculitis? @RheumNow
https://t.co/l7PTyANpjq
https://t.co/MRGbsjaGae
Bella Mehta bella_mehta ( View Tweet)
Reminder of the glucocorticoids (GC) paradigm: don’t use them early during viral replication as morbidity and mortality (M&M) can increase with early use! But GCs CAN prevent the late complications that cause M&M when used at the appropriate time point. #ACR20 @RheumNow https://t.co/l2e0J1nANd
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
#ACR20 Year in Review @JYazdanyMD presenting PEXIVAS results. The proof of efficacy equivalence and safety superiority for the low dose steroid arm is a game-changer @rheumnow https://t.co/bJ1WLL71sB
Richard Conway RichardPAConway ( View Tweet)
