Vitamin D and Lupus Outcomes (11.21.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.
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Pulse Steroids and Mycophenolate in Juvenile Dermatomyositis
JAMA Dermatology has published a pilot study demonstrating the safety and efficacy of intermittent intravenous methylprednisolone pulse (IVMP) therapy plus mycophenolate in 28 patients with JDM. https://t.co/i2HBycbWY9
Dr. John Cush @RheumNow( View Tweet )
Lupus Nephritis study of 136 pts followed 121 mos. Median time to wean GC to 7.5 mg/day, 5 mg/day & D/C was 9, 12 & 29 months post-Dx. Predictors of shorter time to D/C= Sustained CR/SLEDAI-2K≤4, membranous LN, & HCQ. Prolonged GC & renal flares increase damage accrual
Dr. John Cush @RheumNow( View Tweet )
Pulse Steroids and Mycophenolate in Juvenile Dermatomyositis
JAMA Dermatology has published a pilot study demonstrating the safety and efficacy of intermittent intravenous methylprednisolone pulse (IVMP) therapy plus mycophenolate in 28 patients with juvenile dermatomyositis (JDM).
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Putting Steroid Tapering into Practice in SLE
Drs. Yuz Yusof and Ed Vital discuss abstract 1526 (Guidance For Corticosteroid Tapering In Patients With Systemic Lupus Erythematosus: Results From An International Delphi Consensus Project) presented at #ACR25. https://t.co/nqMyy3qNto
Dr. John Cush @RheumNow( View Tweet )
Treating During Pregnancy (11.14.2025)
Dr. Jack Cush reviews the journal articles, news and guidelines from this past week on RheumNow.com
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SLE Prospect. Observational Study of 826 SLE pts over 3 yr for outcomes& IFN signature (IFNGS). 71% were IFNGS-high. IFNGS-high pts were younger. on GC w/ Hi SLEDAI-2K. SLEDAI-2K decreased over time, regardless of IFNGS. By 36mos, 45% had ≥1 flare; higher in IFNGS. https://t.co/c3zHT2GfR5
Dr. John Cush @RheumNow( View Tweet )
Hospital Mortality in Dermatomyositis
A cohort study shows that hospitalized patients with dermatomyositis have higher in-hospital mortality in the presence of active rash, interstitial lung disease, and elevated neutrophil to lymphocyte ratio at admission.
Dermatomyositis (DM) has significiant
PRED-SAFE: Shared Decision-Making Tool for Chronic Prednisone Use
Drs. Jiha Lee and Shivani Garg discuss abstract 1052 (“Prednisone… A Necessary Evil…” Developing an Evidence-Based Benefits vs. Harms Shared Decision-Making Tool (PRED-SAFE) to Support Decisions Around Chronic https://t.co/ZBH61Uzzc8
Dr. John Cush @RheumNow( View Tweet )
Tapering in SELECT GCA: Steroids are the Problem
Dr. Mike Putman reports on abstract 0895 (Impact of Glucocorticoid Tapering in Giant Cell Arteritis: Analysis From the SELECT-GCA Trial) presented at #ACR25.
https://t.co/80Bl49uImB https://t.co/GjlHHjPW2u
Links:
Dr. John Cush @RheumNow( View Tweet )
New ACR 2025 Guidelines for Non-Renal Lupus
MedPage Today
Written by Lisa Sammaritano, MD, of the Hospital for Special Surgery in New York City, and a committee of nearly 50 other experts, the new guideline also stipulates that corticosteroids are OK for gaining symptom control in newly diagnosed patients and when flares erupt, but the duration should
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PET Uptake in Large Vessel GCA – Does tocilizumab help?
Giant cell arteritis (GCA) is the most common form of adult vasculitis in the United States and can be subdivided into those with cranial only symptoms, those with large vessel vasculiti/PMR, and those with mixed features. Non-invasive imaging is key in detecting large vessel
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#ACR25 Abstract 1526
“Guidance for #Steroid Tapering in Systemic Lupus Erythematosus”
101 international experts reached Delphi consensus on CS tapering strategies in #SLE.
🔹 Practical guidance for real-world tapering across disease activity levels and organ involvement. https://t.co/GRlUz3Y3EP
Links:
Romatolog @Nurullah_Akkoc( View Tweet )
Tacrolimus in Lupus Nephritis Management
Prof. Sandra Navarra and colleagues compared the efficacy and safety of tacrolimus and glucocorticoids vs. mycophenolate mofetil (MMF) as a continuous induction-maintenance treatment for class III/IV+V lupus nephritis.
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ACR 2025 Rheumatology Round Up
Drs. Jack Cush & Arthur Kavanaugh, two of rheumatology’s most trusted voices, provide a breakdown of the latest breakthroughs and hottest topics in rheumatology from the 2025 ACR Convergence meeting in Chicago.
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RA: Inject the Steroids
Dr. Richard Conway reports on abstract 1355, "Use of parenteral compared to oral glucocorticoids in early rheumatoid arthritis is superior for chance of being off steroids and escalation of therapy at 1 year," presented at the #ACR25. https://t.co/xFQMIpi75S
Dr. John Cush @RheumNow( View Tweet )
ACR25 Best Abstracts - Day 4
Here's the last installment of our "ACR Best" abstracts as chosen by the RheumNow faculty. Most of these were from the final, day 4, but a few were noteworthy holdovers from day 3. Enjoy!
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#SLE #DORIS #remission is RARE and without #prednisone even rarer
#ASIA #Pacific 5K pts over 10 yrs
A call to do better
82% LLDAS, 70% remission, 31% GC-free remission (REM-0) at least once
abst#595 @ACRheum @RheumNow
#ACRBest https://t.co/OK6sYnqs81
Janet Pope @Janetbirdope( View Tweet )
#ACR25 Clinical Preview by Prof Coates to be applied tomorrow!
GC #steroid burden & Mx
Abstr#738 Survey of #GCA patients in US & EU: 3/4 were still on GC; mean 5.3mg/d
Abstr#1526 International consensus of GC taper in #SLE is available & can be applied in clinic
@RheumNow https://t.co/paw7NGjs4p
Links:
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
What exercise best for steroid-induced osteoporosis? Does it have to be weight bearing?
Turns out anything helps - get out there and don’t let perfect be the enemy of good!
Laura Coates in the #ACR25 meeting review @RheumNow https://t.co/VGH2rz3dzb
David Liew @drdavidliew( View Tweet )
IgG4 - Rare but Rx
Several studies #ACR25 @ACRheum were presented
Outcome measures
Rx
#steroids
#CD19 mAb #Inebilizumab
👍+RCT reduction of flares
BTKi
#Rilzabrutinib
#Zanubrutinib
#JAKi
+RCT of #tofacitinib +steroids vs pred
@ACRheum @RheumNow #ACR25
1163 LB02 0239 1172 https://t.co/xC3wgaN9bk
Janet Pope @Janetbirdope( View Tweet )
In RA, “strong bones” can give false reassurance.
Pts with higher baseline BMD had faster bone loss, often tied to GC use and less osteoporosis treatment. Undermanagement, not biology, may drive decline.
@RheumNow #ACR25 Abstract#2244 https://t.co/N421ESAUy9
Jiha Lee @JihaRheum( View Tweet )
Infection vs steroid sparing in PMR/GCA/AAV studies with steroid-sparing Rx
GiACTA (1, top right) aside,
- low infection rates
- the more steroid saved, the less the infection risk
Infection risk in vasculitis is driven by steroid, not DMARD
#ACR25 ABST2526 @RheumNow https://t.co/UprbxUQyQC
David Liew @drdavidliew( View Tweet )
#1727
360k+ postmenopausal women w osteoporosis: >1/3 untreated patients were at v high fracture risk, yet few received recommended anabolic or antiresorptive therapy.
Even among treated women at very high risk, >50% were still on oral bisphosphonates
@RheumNow #ACR25 https://t.co/9S66tAU68P
Mrinalini Dey @DrMiniDey( View Tweet )
#ACR25 Please find my video interview with Prof Edward Vital @edvital on their work on International Consensus of Glucocorticoid Tapering Guideline in #SLE #lupus Abstr#1526 @RheumNow
https://t.co/MnQdcdASkG https://t.co/b7GMcnFU2m
Links:
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
