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Steroids

"I think we can get rid of maintenance prednisone in nonrenal lupus" (but not in renal lupus) "...prednisone contributes to some organ damage (but not renal)" Organ damage is multifactorial -traditional risk factors, disease activity & steroids - Dr. Michelle Petri #UTSWSLE2022 https://t.co/N9NMPgtPEn
Dr. John Cush @RheumNow( View Tweet )
May 07, 2022
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What is JAKne? (5.6.2022)

May 06, 2022

Dr. Jack Cush reviews the news, journal reports, FDA actions, new side effects and changing prevalence of Gout.




  1. Gout affects >10 million (4%) in USA, but now w/ more ethnicity, with highest risk in Native Hawaiians (HR 2.21), followed by Black (1.34) and Japanese (1.14);

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BSR Guideline on Idiopathic Inflammatory Myopathy

May 05, 2022

The British Society of Rheumatology (BSR) has published evidence-based guidelines for idiopathic inflammatory myopathy (IIM) affecting juvenile and adult-onset disease. This rare condition has an estimated prevalence of 5-15 per 100,000 persons.

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Retrospective study of 71 adult-onset Still’s disease pts Rx 1st w/ High-dose glucocorticoids shows 41% failed to respond (poor outcome) by week4 w/ WBC as best predictor. If WBC < 13K 60% responded; if ≥13K only 23.5% https://t.co/tMNDgoqP14 https://t.co/xJrIEUU6iK
Dr. John Cush @RheumNow( View Tweet )
May 04, 2022
Gout pills injection

Allopurinol Use Does Not Increase Mortality in Gout with Chronic Kidney Disease

May 03, 2022

A population based trial has shown that allopurinol use dose escalation and achieving target uric acid levels (with allopurinol), was not associated with increased mortality in patients with gout and concurrent CKD



To examine the relation of allopurinol initiation, allopurinol dose

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Intraarticular Steroids in Hip Osteoarthritis - Do They Work?https://t.co/AP9jo96xQo https://t.co/tYvP20Qpqh
Dr. John Cush @RheumNow( View Tweet )
May 01, 2022
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Intraarticular Steroids in Hip Osteoarthritis - Do They Work?

Apr 27, 2022

The efficacy of ultrasound guided intra-articular hip injection of corticosteroid in adult hip osteoarthritis (HOA) was shown to be effective when added to conventional current treatment. But was this a clinically meaningful outcome?

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Systematic literature review of studies where steroids were used as initial "Bridge Therapy" in RA patients - included 10 studies, but only 4 RCTs w/ protocolized discontinuation - these showed 22% were still on GC @ 12 mos, 10% @24 mos https://t.co/aRLhptAASe https://t.co/lg4msIyQfc
Dr. John Cush @RheumNow( View Tweet )
Apr 27, 2022
Useful TST (PPD)/IGRA interpreter website for TB testing. A 31 yoM Texan w/ +IGRA only (true pos) has risk of active TB & INH hepatitis 0.1% & 0.4%. But if this was 60 yoF from Iraq on TNFi & pred the same risks are 20% & 2.3% https://t.co/M18cHuLrXu https://t.co/zIoFY4abXN
Dr. John Cush @RheumNow( View Tweet )
Apr 09, 2022
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RheumNow Podcast – What You Do For & What You Do To the Patient (4.8.2022)

Apr 08, 2022

Dr. Jack Cush reviews the news and journal articles from the past week and discusses the use of fibroscan in RA, steroid hip injections in OA and famous quotes from a famous cardiologist.




  1. CorEvitas Registry study of173 Axial #PsA pts showed 6 mos of bDMARD/tsDMARD resulted

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Short-Term (not Long-Term) Benefits to Intraarticular Hip Steroid Injection

Apr 07, 2022

A single ultrasound guided intra-articular hip corticosteroid injection can be quite effective in patients with hip osteoarthritis (OA).

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Steroids associated with adverse events during pregnancy ⁦@UmaMahadevanIBD⁩ ⁦@MayoClinicGIHep⁩ https://t.co/VR5CZUH1S7
Edward Loftus @EdwardLoftus2( View Tweet )
Apr 05, 2022
Retrospective cohort hospital study of 228 children with MIS-C; 215 patients (median age 8 yrs, 63% boys) shows that orticosteroid monotherapy is a reasonable management option for a subset of patients with MIS-C, particularly those with mild disease https://t.co/HLSR5zOseU https://t.co/5z7I9SVcxI
Dr. John Cush @RheumNow( View Tweet )
Apr 01, 2022
Effect of Intraarticular Steroid Shots on Knee OA Outcomes In patients with osteoarthritis of the knee, intra-articular injections of steroids did not increase rates of either disease progression or subsequent knee replacement surgery, researchers said.https://t.co/KlNj1GABlb https://t.co/2npPTNSlSA
Dr. John Cush @RheumNow( View Tweet )
Mar 24, 2022
malar lupus

Poor Outcomes in Lupus Patients Not at Target

Mar 22, 2022

A prospective, longitudinal systemic lupus erythematosus (SLE) cohort study examined outcomes and showed that failure to control SLE was common and associated with poorer outcomes including organ damage, glucocorticoid exposure, poor quality of life, and increased mortality.

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Effect of Intraarticular Steroid Shots on Knee OA Outcomes

MedPage Today
Mar 22, 2022

In patients with osteoarthritis (OA) of the knee, intra-articular injections of steroids did not increase rates of either disease progression or subsequent knee replacement surgery, researchers said.



Among more than 560 OA patients in a long-running French cohort, 6.0% of those

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"Going to a dermatologist is like going to a bagel shop, you're gonna get a 'smear'" - Dr. K Gordon #RNL2022 on use of topical corticosteroids as a tool that we should not forget for pts w/#psoriasis https://t.co/vCjMyKe5AE
TheDaoIndex @KDAO2011( View Tweet )
Mar 20, 2022
Completed Early RA prevention trials using agents like steroids, RTX, atorvastatin, abatacept No sig difference in steroids, atorvastatin RTX delayed onset but no overall diff Abatacept decreased RA progression at 1.5 years @RheumNow #RNL2022 https://t.co/v7WxI2P7r5
Robert B Chao, MD @doctorRBC( View Tweet )
Mar 20, 2022
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Consequences of TNF inhibition (3.18.2022)

Mar 18, 2022

This week we're going to talk about the downside of TNF inhibitors, a few interesting observations in gout, and yes, kids do get COVID. We're also going to preview what's coming in April (hint: it's about PsA). This and more as Dr. Jack Cush reviews the news and journal articles from the past

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Disappointment Behind Acute Gout Hospitalizations

Mar 16, 2022

Analysis of emergency department visits from two UK hospitals shows a high rate of hospitalization, and low use of urate-lowering therapies (ULT) and treat-to-target (T2T) management. 



Between 2017 and 2020 there were 1,220 emergency attendances for gout flares -  23.5% required

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RheumNow Live is Coming to Town (3.11.2022)

Mar 11, 2022

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

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Tocilizumab Works Best in Non-Mechanical Ventilated COVID-19 Patients

Mar 04, 2022

JAMA has published a meta-analysis of 15 studies of hospitalized patients with COVID-19 treated with tocilizumab and corticosteroids, showing that a clinically meaningful mortality benefit from tocilizumab (and steroids) was best seen in those not requiring invasive mechanical ventilation (

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Increased SLE Flares with Hydroxychloroquine Reduction

Mar 01, 2022

Concerns about the long-term safety of hydroxychloroquine (HCQ) often results in dose reduction or drug discontinuation; yet a current study shows that, for those in remission, HCQ taper/discontinuation resulted in a significantly higher rate of SLE flares.



While there is literature

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RheumNow Podcast - RWCS 2022 Roundup (2.19.2022)

Feb 21, 2022

Drs. Jack Cush and Artie Kavanaugh review the highlights of the RWCS (Rheumatology Winter Clinical Symposium) from Maui.


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CV Risk Management in Rheumatic Disease Patients

Feb 15, 2022

The European League against Rheumatism (EULAR) has developed recommendations for cardiovascular risk (CVR) management in rheumatic disease patients based on literature review and expert consensus.



These recommendations are applicable to patients with gout, vasculitis, systemic

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