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Steroids

NOBILITY: a Trial of Obinutuzumab in Proliferative Lupus Nephritis

Oct 18, 2021

B-cell depletion therapy with obinutuzumab, a type II anti-CD20 monoclonal antibody, in lupus nephritis patients was shown to be effective in in combination with standard lupus therapies.



Prior trials testing the utility of type I anti-CD20 antibody therapies - rituximab and

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Are You a High or Low Glucocorticoid Prescriber? https://t.co/QbJzlrVMiV https://t.co/dZgJPKjisx
Dr. John Cush @RheumNow( View Tweet )
Oct 18, 2021
Retrospective study hospitalized new-onset systemic JIA (2008-19):52 children’s hospitals & 534 sJiAshows 29% rx w/ biologics & 58% steroids. Over time Biologic use increased & MTX decreased. Biologic correlated w/ Hi hospital volume, ICU stay, later years https://t.co/blbOps9zVQ

Dr. John Cush @RheumNow( View Tweet )

Oct 15, 2021

Are You a High or Low Glucocorticoid Prescriber?

Oct 15, 2021

A recent analysis shows thta glucocorticoids (GCs), usually recommended for short-term use in rheumatoid arthritis (RA), are variably used by rheumatologists, and that provider preference is a strong predictors of long-term glucocorticoid use.

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RheumNow Podcast – Quackademia (10.15.2021)

Oct 14, 2021

Dr. Jack Cush reviews the FDA approvals, news and the latest journal articles from the past week on RheumNow.com.

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Still’s Disease Following COVID-19 Vaccination

Oct 14, 2021

Both systemic onset juvenile idiopathic arthritis (sJIA) and adult-onset Still’s disease are acquired autoinflammatory disorders of uncertain etiology. Yet recent reports of AOSD onset and flare following COVID-19 vaccinations may have important mechanistic implications.

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FDA Approves Avacopan for ANCA-Associated Vasculitis

Oct 11, 2021

October 8, 2021 the U.S. Food and Drug Administration (FDA) approved avacopan (trade name: Taveneos), an oral complement 5a receptor inhibitor, as an adjunctive treatment of adult patients with severe active anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis). It is

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Post-Arthroscopic Increase in Septic Arthritis

Sep 27, 2021

A longitudinal study from Iceland shows an increasing number of native joint infections (NJI), with iatrogenic, postarthroscopic infections being of particular concern.



Between 2003-2017 they identified 299 NJI (40 children and 259 adults) with more infections in men (33% women vs 67

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Serious Infection Risk High in Patients With Lupus

MedPage Today
Sep 17, 2021

Patients with systemic lupus erythematosus (SLE) had two to four times higher risk for serious infection requiring hospitalization, a nationwide Swedish study found.



In a multivariate analysis that adjusted for age, sex, region of residence, and education, the hazard ratio for serious

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RheumNow Podcast – Do More DMARDs Mean More Switching? (9.17.2021)

Sep 16, 2021

Smartphones and diet; COVID-19 and the numbers - reassuring or not, and what about masks?; and do more drugs mean more switching, less persistence, and patient adherence goes up...or down? All this and more news and journal reports in this week's episode.

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Canakinumab Use in Periodic Febrile Disorders

Sep 16, 2021

A retrospective records review of patients with periodic fever syndromes (PFS)  receiving IL-1 inhibitor treatment with canakinumab (CAN), shows CAN to be effective and safe in a variety of PFS patients.

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Steroid (GC) discontinuation from the BeSt and IMPROVED trials shows that w/ GC d/c 40% of RA pts Flare and 50-60% restart GC. Similar outcomes w/ 2nd attempt at GC d/c. Lower DAS28 scores had better odds of GC D/C. https://t.co/PtbgONNMwW

Dr. John Cush @RheumNow( View Tweet )

Sep 02, 2021

TNF Inhibitor Induced IgA Vasculitis in IBD

Aug 31, 2021

A new descriptive series shows an uncommon association between IgA vasculitis (IgAV) and inflammatory bowel diseases (IBD), with most cases interestingly arising after  or during anti-TNF-α therapy.



A retrospectively analysis of the GETAID and FVSG networks identified, 43 patients

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Large US Behcets disease registry in USA: 1023 pts w/ more women (79%) than expected. Most frequently Meds: steroids (68%), colchicine-COL (55%), MTX (22%), TNFi (29%); only 3.2% apremilast. Less COL, CsA, CTX vs use in Egypt/Turkey/Iran https://t.co/hpHO6C8LKW

Dr. John Cush @RheumNow( View Tweet )

Aug 31, 2021

EULAR Points on Managing Difficult Rheumatoid Arthritis

Aug 19, 2021

A EULAR task force has promulgated several points to consider in managing difficult-to-treat RA. These "points" are unique in directing the rheumatologist's attention to the potential for misdiagnosis and the impact of comorbid conditions on what is perceived as poorly controlled RA.

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Tocilizumab in Refractory Skin and Joint Scleroderma

Aug 18, 2021

The interleukin-6 inhibitor, tocilizumab (TCZ), was studied in a cohort of difficult systemic sclerosis (SSc)  and was shown to be effective in refractory joint and skin disease with good long-term retention rates and disease stabilization.



TCZ is currently FDA approved for use in SSc

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Mepolizumab Dosing in Eosinophilic Granulomatosis with Polyangiitis

Aug 11, 2021

A new European real world experience study shows that mepolizumab is effective at both 100 or 300mg every 4 weeks in patients with the rarely encountered eosinophilic granulomatosis with polyangiitis (EGPA; or Churg-Strauss Syndrome). 

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Takayasu's responds to Tofacitinib - 53 pts given TOF + glucocorticoids (GCs) (n=27) or MTX + GCs (n=26). At 12 mos complete remission (CR) more with TOF (88% vs 56%, p=0.02), w/ lower GC use and relapse rates ((12% vs 35%, p=0.052) https://t.co/qgziyIhKgV

Dr. John Cush @RheumNow( View Tweet )

Aug 11, 2021

RheumNow Podcast – Saphnelo (Anifrolumab) Approved for Lupus (8.6.2021)

Aug 06, 2021

It was a banner week at the FDA; a new drug approval you should know about; a lot of information about pregnancy and safety; and an interesting case plus a question from one of our readers submitted via Back Talk. This and more in this week's podcast. Let's dive in.

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Skin Involvement with HMGCR Necrotizing Myositis

Aug 04, 2021

The Journal of Autoimmunity reports that anti-HMRCR antibody positive, necrotizing myositis patients frequently have cutaneous lesions, moreso than previously reported.



Anti-3-Hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) antibodies have been linked to the immune-mediated

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FDA Approves Anifrolumab in SLE

Aug 02, 2021

AstraZeneca announced today that anifrolumab (Saphnelo or anifrolumab-fnia) was approved by the the Food and Drug Administration (FDA) for that treatment of adult patients with moderate to severe systemic lupus erythematosus (SLE) who are receiving standard therapy.  



Saphnelo the 

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Fibromyalgianess Influences Steroid Persistence

Jul 30, 2021

"Fibromyalgianess" is highlighted as a risk factor for undue, extended glucocorticoid use in rheumatoid arthritis (RA) patients, according to Wallace and colleagues in Rheumatology.



Fibromyalgianess is associated more disability and poor responses to RA treatment and can be

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RheumNow Podcast – Psoriatic Arthritis Without Psoriasis (7.30.2021)

Jul 30, 2021

How much psoriasis do you need to have in order to have psoriatic arthritis? This plus a review of rheumatology and COVID news from the past week on RheumNow.com.

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ICYMI: EULAR guidelines rec starting prednisone dose in #PMR to be between 12.5-25mg/d. A cross sectional study of 138 pts (63M, 75F, age 73.4 yes) saw the mean starting dose to be 19.2±7.7 mg.  https://t.co/Yf3yqRRMCK

Dr. John Cush @RheumNow( View Tweet )

Jul 29, 2021
Steroid (GC) withdrawal studied in T2T RA cohort of 207 RA pts (F/U 39 mos); Only 60% discontinued GC, w/ low risk of flare. BUT D/Cs were SLOW w/ only 9.7%, 26.6%, 48.0% & 58.6% at 6 mos, 1, 2 & 3 yrs - median time to cessation = 27 mos https://t.co/h02aueYKwN

Dr. John Cush @RheumNow( View Tweet )

Jul 23, 2021
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