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A Review of Intracranial GCA
A comprehensive review in Rheumatology on intracranial giant cell arteritis (icGCA) stresses that GCA is both an intracranial and extracranial large vessel vasculitis, with the former having unique presentations, and outcomes.
How to properly use steroids in early RA
Guidelines differ on the early treatment of RA – ACR suggests not to use glucocorticoids (GC) and EULAR updated recommendations for RA treatment presented at #EULAR2025 continued to suggest early treatment with MTX and glucocorticoids. We do know that it is not easy to get a significant minority of RA patients off of prednisone.
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2025 update of EULAR recommendations on lupus nephritis
At the 2025 EULAR congress in Barcelona, Prof Dimitrios Boumpas presented a summary of the updated EULAR recommendations on the management of lupus nephritis (LN). The most significant change in the treatment paradigm of LN is that the historic standard of care (SOC) (i.e.
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Glucocorticoid Tapering in SLE
Dr. Yuz Yusof discusses abstract POS1224 presented at the 2025 EULAR meeting in Barcelona, Spain.
https://t.co/oI992YLvnB https://t.co/mPmMxcpMey
Dr. John Cush RheumNow ( View Tweet)
JAMA Clinical Challenge - 34-yoF with Forearm Pain and Stiffness. 1 yr of progressive skin tightening over forearms, tibia, LOM of fingers & elbows. Denied DM, Raynauds. Worse after tennis, better w/ steroids. Increased ANA, eosinophils, CRP, aldolase - your Dx? https://t.co/5VrE4OpZ4N
Dr. John Cush RheumNow ( View Tweet)
JAMA Clinical Challenge - 34-yoF with Forearm Pain and Stiffness. 1 yr of progressive skin tightening over forearms, tibia, LOM of fingers & elbows. Denied DM, Raynauds. Worse after tennis, better w/ steroids. Increased ANA, eosinophils, CRP, aldolase - your Dx? https://t.co/ppuzIB4iRf
Dr. John Cush RheumNow ( View Tweet)
UK study of 17472 newly Dx #RA pts (10997 MTX, 4,540 csDMARDs; 13680 steroids-CS) w/ 1307 Serious Infx (SI) (3/100PY) & 311 SI deaths. MTX signif decr. SI (adj HR 0.72) & CS no effect HR 0.99. SI assoc w/ age, smoker, comorbidity, seropositive, high DAS28. 1 DAS unit incr SI https://t.co/Zmsuaf7Rw3
Dr. John Cush RheumNow ( View Tweet)
How to properly use steroids in early RA
Guidelines differ on the early treatment of RA – ACR suggests not to use glucocorticoids (GC) and EULAR updated recommendations for RA treatment presented at #EULAR2025 continued to suggest early treatment with MTX and glucocorticoids. https://t.co/FakKxRot0p
Dr. John Cush RheumNow ( View Tweet)
Steroids, Not JAKi, Are the Real Infection Risk
Dr. David Liew reporting at EULAR 2025 in Barcelona, Spain.
https://t.co/rLpyo1UNjd https://t.co/bDfdLTEM1N
Links:
Dr. John Cush RheumNow ( View Tweet)
Sometimes you hear:
“PMR dose steroids don’t really matter”
Errrrr…
(You wouldn’t accept this steroid exposure in any other disease. Never)
#EULAR2025 POS0139 @RheumNow https://t.co/o6w2RpaGBj
David Liew drdavidliew ( View Tweet)
#EULAR vs #ACR #RA #recommendations
Do you agree that #ERA pts should receive #glucocorticoids
@RheumNow #EULAR2025
@eular_org
Janet Pope Janetbirdope ( View Tweet)
Management of AAV:
1.High dose GC f/b reduced dose taper ‼️caution in pts w/severe renal dz and RTX induction.
2. RTX effective for induction and maintenance, best for relapses.
3.PLEX: in RPGN pts if accesible ⚠️ risk for infection.
4.Avacopan: for faster GC weaning. No https://t.co/kfZ4gM38KG
Links:
Adela Castro AdelaCastro222 ( View Tweet)
Pearls on EGPA:
1. GC are mainstay for mild
dz
2. Organ threatening/relapsing➡️CYP (RTX alternative)
3. W/o organ threatening➡️ anti-IL-5/IL-5R.
4. IL5i are less effective for ENT
5. Consider sx for nasal polyps.
#EULAR2025 @RheumNow https://t.co/zoJEWxafsN
Links:
Adela Castro AdelaCastro222 ( View Tweet)
“That is why this task force continues to say: nothing is better than methotrexate and glucocorticoids to start”
- Josef Smolen, on RA treatment
#EULAR2025 @RheumNow https://t.co/AbkgWS8tvH
Links:
David Liew drdavidliew ( View Tweet)
#EULAR new #RA #recommendations
J Smolen presents justification for
#MTX +#glucocorticoids at onset
do you agree?
Diff from #ACR
#EULAR #Recommendations II
#EULAR2025 @RheumNow https://t.co/wqCX5HA87q
Janet Pope Janetbirdope ( View Tweet)
Recommendations for RA management at #EULAR2025
- MTX [or other csDMARDs] and steroids still remain the first line- nothing beats that!
- ofcourse minimize steroids!
- rather than stopping meds at remission, reducing doses may be a better solution.
Not much changed.
@RheumNow https://t.co/NK5ejsgjWV
Bella Mehta bella_mehta ( View Tweet)
#EULAR2025 Abstr#OP0324 Cohort study of #lupus nephritis in Greece showed Earlier GC Discontinuation (D/C) & flare protection post-D/C is associated with renal response, low disease activity & HCQ use at GC D/C. Membranous LN & recent diagnosis were assoc w early GC D/C @RheumNow https://t.co/agFgyG5eaS
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
What kills in GCA?
Greek national prospective cohort, small numbers and no doubt some channeling bias, but:
Steroids (absence of DMARD use) is more of a factor than CV disease in GCA mortality.
With new options, all GCA pts should be on something
#EULAR2025 POS0960 @RheumNow https://t.co/Wmvf6tEvaF
David Liew drdavidliew ( View Tweet)
Stabilize the pts with HLH with steroids when still trying to figure out the diagnosis of #HLH/ #MAS
Many drugs can be used...but important to balance infection risk with immunosuppression
These are critical pts. Be vigilant..
#EULAR2025 @RheumNow https://t.co/id4ae3SWtj
Links:
Bella Mehta bella_mehta ( View Tweet)
Treatment strategies for steroid free management of #relapsingpolychondritis
56 patients from a single center
#POS0149 #EULAR2025 @RheumNow https://t.co/d4I56opS02
Bella Mehta bella_mehta ( View Tweet)
