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Steroids

Immune Necrotizing Myopathy

Oct 26, 2020

A full read review of immune-mediated necrotizing myopathy is portrayed as a distinct subtype of inflammatory myopathies first described in 2004.



This form of myositis has been associated with antibodies to signal recognition particle (anti-SRP) or anti-3-hydroxy-3-methylglutaryl-coA

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Clinical Trial Boom or Bust in Severe COVID-19

Oct 20, 2020

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

Oct 08, 2020

Two biologic therapies showed promise in the treatment of refractory or relapsing eosinophilic granulomatosis with polyangiitis (EGPA) in a retrospective European study.



Among 63 patients who were treated with rituximab (Rituxan), remission or partial responses at 1 year were observed

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Sustained Remission Off Therapy Unlikely in GPA

Oct 08, 2020

A French Vasculitis Study Group analysis of their granulomatosis with polyangiitis (GPA) reveals that after 10 years, only 7% of GPA patients achieved sustained remission off therapy (SROT) and have never relapsed.

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Systemic Steroids Reduce Mortality in COVID-19

Oct 06, 2020

JAMA Internal Medicine reports an analysis of COVID-19 clinical trials showing that critically ill patients with COVID-19 treated with systemic corticosteroids have an overall lower mortality rate.

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"Prednisone >30 mg/day for > 4 weeks, patients should be on PJP prophylaxis." Image shows when to start/stop PJP prophylaxis Dr. Kevin Winthrop on Risks/Prevention of OI @UTSWRheum Grand Rounds @rheumnow https://t.co/nXuWYRxbgy
Oct 05, 2020
14203 early RA cohort looked at adherence to quality standards of care (DMARD use, steroids, early F/U care) and showed adherence lessened need for future hospitalisation (adj HR 0.85); most impact from early DMARDs, worst from steroid use https://t.co/hzICGWyht2

Dr. John Cush RheumNow ( View Tweet)

Sep 30, 2020

RheumNow Podcast – Cardiovascular Risk in Psoriatic Disease (9.25.20)

Sep 24, 2020

Dr. Jack Cush reviews the news and Journal articles from the past week on RheumNow.com.

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EULAR Updated 2019 Recommendations for Psoriatic Arthritis Management

Sep 24, 2020

In June 2020, we failed to report on the ARD publication updating the 2019 update the European League Against Rheumatism (EULAR) recommendations for the pharmacological treatment of psoriatic arthritis (PsA) - these are presented below.



This guideline committee included 28

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Ann Int Med shows again that steroids increase serious infection risk in a dose dependenet manner, but even 5 mg of prednisone or less also gives a small but significant risk of serious infection in RA patients on DMARDs (claims data from Medicare & Optum) https

Dr. John Cush RheumNow ( View Tweet)

Sep 22, 2020
Uncontrolled retrospective observational study of 31 RA-ILD DMARD refractory pts treated with RTX showed RTX to reverse the PFTs decline (∆%pFVC +8.06%; ∆%pDLCO +12.7%) while reducing median prednisone dose at 1 yr. @32 mos, 74% still on RTX.

Dr. John Cush RheumNow ( View Tweet)

Sep 16, 2020
Candian study of 376 pregnancies (284 F) with #SLE and drug use: only 24.2% on antimalarials, 8.2% azathioprine, 19.7% steroids & 4.8% on NSAIDs during pregnancy. 1st trimester discontinuations seen in 16.7% of HCQ & 29.2% AZA https://t.co/a1SMwZuSlm

Dr. John Cush RheumNow ( View Tweet)

Sep 13, 2020

ACR 2020 Reproductive Guidelines - Lactation Guidance

Sep 10, 2020

In this third excerpt from the ACR guidelines on managing reproductive health issues in rheumatic disease patients, we present recommendations regarding the use of glucocorticoids and guidance on lactation and medication use post-partum.

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RheumNow Podcast – To Celiac Test or Not? (9.4.20)

Sep 04, 2020

Dr Jack Cush reviews the news, journal articles and takes a few Back Talk questions this week:

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Treatment Options for Extraintestinal IBD

Sep 03, 2020

Extraintestinal manifestations (EIMs) frequently accompany inflammatory bowel disease, often augmenting morbidity and mortality are associated with disease activity and may increase the need for surgery or treatment escalation.  A recent review in GUT details the treatment options for patients

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Metanalysis of 11 RCTs (1353 patients) shows that saline injections are as effective as corticosteroids, platelet-rich plasma and hyaluronic acid for hip osteoarthritis pain https://t.co/z7jhOSUwQU

Dr. John Cush RheumNow ( View Tweet)

Sep 03, 2020

Steroid Bursts and Adverse Events

Sep 01, 2020

Annals of Internal Medicine has published a population based study showing that the use of (short term) corticosteroid bursts were associated with GI bleeding, sepsis, and heart failure, often occurring within the first month of steroid therapy. 



Using Taiwans health care

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RheumNow Podcast – Rheum Lives Matter (8.28.20)

Aug 28, 2020

Dr. Jack Cush reviews the news and journal articles from the past week. Of mice and men in cartilage, the efficacy of JAK inhibitors in patients who are having skin problems, nrAxSpa has its own diagnostic code, metformin, talking about Back Talk, plus so much more.

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Update on Polymyalgia Rheumatica and Giant Cell Arteritis

Aug 24, 2020

JAMA has published a clinical update of recent studies on GCA. While PET/CT scanning are novel means of demonstrating activity, they have not changed the diagnostic approach to GCA or PMR and although there are no new proven treatment strategies for PMR beyond glucocorticoids, the FDA has

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Canakinumab Tapering in Still's Disease

Aug 20, 2020

You can reduce - but not stop - canakinumab therapy in patients who are in complete clinical remission in children with systemic juvenile idiopathic arthritis.

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Study 137 GCA pts (1993 -2015) - those w/ diabetes were less likely to have (+)Tem artery Bx & more likely to relapse. ARB Rx prior to diagnosis showed greater success discontinuing glucocorticoids.

Dr. John Cush RheumNow ( View Tweet)

Aug 18, 2020

RheumNow Podcast - The SARS-CoV-2 Update (8-14-20)

Aug 14, 2020

Dr. Jack Cush updates the news and journal articles from the past week on RheumNow.com, with information on enthesitis, nr-Ax-SpA, UAB, Blockbuster Rheum Drugs and use of ACE inhibitors.

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Rheumatic Diseases, Drugs and COVID-19 Guidelines

Aug 13, 2020

Several recent publications have focused on the risk and outcomes of rheumatic disease (RDD) and autoimmune patients who become infected with SARs-CoV-2.

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Long-Term Rituximab in ANCA-Associated Vasculitis

Aug 06, 2020

The Annals of Internal Medicine reports that biannual rituximab infusions over 18 months was effective at maintaining remission in patients with antineutrophil cytoplasmic antibody–associated vasculitis (AAV).

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Methotrexate Not Associated with Interstitial Lung Disease

Aug 05, 2020

A case-controlled study shows that methotrexate (MTX) use in rheumatoid arthritis (RA) is not associated with interstitial lung disease (ILD) according to a report in the European Respiratory Journal.



Researchers examined the associatioin by comparing 410 RA patients with

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