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Steroids

Lung Involvement in Still's Disease

A multicentre registry observational study assessed lung involvement in a cohort of Still’s disease patients, affirming pleuritis as most common and that parenchymal lung inflammatory disease is very uncommon in both children and adults.

A total of 90 Still's patients with lung

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ICYMI: VITAL Info on Autoimmune Disease (2.9.2024)

Dr. Jack Cush reviews the journal reports from the past week on RheumNow.com. Highlights are summarized by three songs: "Stairway to Heaven", "You're No Good", and "How Long (has this been going on)".

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A Modifiable Vascular Risk in SLE

MedPage Today

Atherosclerosis progression was more than twice as common in younger people with SLE than in healthy controls in a prospective study from Greece, but the rate difference narrowed substantially with sustained SLE remission and conventional cardiovascular risk factor management.

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Best of 2024: Upside/Downside of Steroids in Lupus Nephritis

A systematic review of randomized clinical trials of patients with biopsy-proven lupus nephritis demonstrates both the benefits and harms to early glucocorticoid regimens on lupus outcomes.

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Great table re:side effects of even low dose steroids in RA Likely generalizes to other diseases ie PMR, SLE P in prednisone stands for poison! #ACR24 @RheumNow https://t.co/2bFy6dwl96 https://t.co/YDtjSX054I
Dr. John Cush @RheumNow( View Tweet )
TAPIR study of continuing vs stopping steroids in ANCA vasculitis in remission. Relapse at month 6 in 16% vs 4%. OR 4.22, but low rate in either group. If treated Rituximab, no difference! Merkel et al. @RheumNow #ACR24 Abstr#0774 #ACRbest https://t.co/F9DOBLrjVq https://t.co/BtphAuEopA
Dr. John Cush @RheumNow( View Tweet )

Best of 2024: Good Clinical Practice Recommendations on Glucocorticoid Withdrawal and Adrenal Insufficiency

Glucocorticoids are widely prescribed as anti-inflammatory and immunosuppressive agents. This results in at least 1% of the population using chronic glucocorticoid therapy being at risk for glucocorticoid-induced adrenal insufficiency. This risk is dependent on the dose, duration and potency of

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Best of 2024: Inadequate Zoster Vaccination in Immunocompromised Patients

A VA study of shows that recombinant zoster vaccine (RZV) vaccination in immunocompromised patients or those receiving immunosuppressive medications is insufficient, given these are high risk individuals.

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Bah Humbug Vitamin D (12.20.2024)

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.

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Best of 2024: Determinants of Gout Flares

Approximately 12 million US adults in the US have gout. Two recent literature reports in JAMA and Arthritis Care & Research highlight contributors to gout flares.

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Review of IgA Vasculitis (Henoch–Schönlein Purpura) - the freq of glomerulonephritis is higher in adults than children and tends to present more severely. Rx w/ 1st line steroids, Other agents: Colchicine, dapsone, MTX (Minor dz), CsA, tacrolimus, MMF (steroid sparing)… https://t.co/tB5fll3RfN https://t.co/knc7KesyRj
Dr. John Cush @RheumNow( View Tweet )

ICYMI: Are Emulation Trials a Fantasy?

Are emulation ‘trials’ helpful, despite the biases that occur with observational data, or do they truly mimic the results of randomized controlled trials (RCTs)?

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ICYMI: Say Goodbye to Methotrexate in PMR?

For decades, glucocorticoids (GCs) have formed the backbone of polymyalgia rheumatica (PMR) management. Whilst previously there was a sense that a “low” GC dose with limited duration was used, we now appreciate just how heterogenous the disease course of PMR can be, with many

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Drug-Free Remission in Giant Cell Arteritis is Uncommon

A Spanish retrospective registry study of patients with giant cell arteritis (GCA) found that 3-4 years after diagnosis, only 21% of patients with GCA successfully reached the sustained drug-free remission (SDFR). But if SDFR was achieved, the likelihood of experiencing recurrence was

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Primary Hypophosphatemia (HYPOPH) - Japan study 50,136 adults w/ 424,434 alk phosphatase (ALP) tests. Persistent HYPOPH seen in 0.54% (273) due to cancer(30%), steroids(21%), DMARDs (16%). Unexplained HYPOPH had pain, muscle weakness, fatigue & could have primary HYPOPH… https://t.co/kGPSXSYEZI https://t.co/RtwSRnzeU0
Dr. John Cush @RheumNow( View Tweet )
Primary Hypophosphatemia (HYPOPH) - Japan study 50,136 adults w/ 424,434 alk phosphatase (ALP) tests. Persistent HYPOPH seen in 0.54% (273) due to cancer(30%), steroids(21%), DMARDs (16%). Unexplained HYPOPH had pain, muscle weakness, fatigue & could have primary HYPOPH… https://t.co/8RbSnhS3vl https://t.co/NdRIA4oREr
Dr. John Cush @RheumNow( View Tweet )

ACR24: Rheumatology Roundup

Join Drs. Jack Cush and Artie Kavanaugh as they review 15+ presentations and abstracts from the 2024 ACR Convergence meeting in Washington, DC.

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Worried about CV Risk and JAKi? What about the Steroids? Dr. David Liew discusses abstracts 1981 and 2673, presented at #ACR24 https://t.co/OkMgIqxl2A https://t.co/1DVapGcWUn
Dr. John Cush @RheumNow( View Tweet )
Maximizing DMARDs to Strive for Steroid-Free Remission in RA In 1950, three scientists won the Nobel Prize for discovering steroids, initially hailed as a "miracle cure" for RA. However, within a year, unrelated side effects like pain and fatigue emerged. Despite these issues,… https://t.co/dQEjXzxU0U https://t.co/NqyZHfBiId
Dr. John Cush @RheumNow( View Tweet )

Maximizing DMARDs to Strive for Steroid-Free Remission in RA

In 1950, three scientists were awarded the Nobel Prize for their groundbreaking discovery of steroids, heralded at the time as a "miracle cure" for rheumatoid arthritis (RA). However, just a year after their introduction, evidence began to surface regarding the harmful side effects

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A new score to quantify GCA inflammation? The treatment paradigm for Giant Cell Arteritis (GCA) has been a binary approach to the presence or absence of vasculitis. When GCA is present, we institute high doses of glucocorticoids for treatment of the inflammatory process. #ACR24… https://t.co/b5H7KOtZPC https://t.co/AvrwHcXI7r
Dr. John Cush @RheumNow( View Tweet )

Is Your Practice Up to Date? New Guidelines for SLE Nephritis

Randomized controlled trials (RCTs) drive guidelines; guidelines drive clinical practice. Because updated guidelines lag trials by many years and dissemination of guidelines takes additional time, rheumatologists often practice “behind the data.” The 2024 ACR Guidelines for the Management of SLE

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Methotrexate to Prevent RA, Clear as Mud

Intervention in individuals predisposed to develop RA, with a holy grail of prevention of RA, has long been a hot topic. The 4-year results of the TREAT EARLIER study, presented at Tuesday’s oral abstract session, show that methotrexate appears to prevent the development of RA in high risk

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Prof Petri reports the ff predictors of fracture in SLE: -older age -Caucasian race -female sex ⚠️ Prednisone (but not recent IM triamcinolone or IV methylpred) is a MAJOR risk factor. When possible, avoid prednisone! @RheumNow #ACR24 #ACRbest abs2679 @rheumarhyme https://t.co/q2NMRaYsAF
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