SPRINGBOARD: Extended-release Intra-articular Corticosteroid Injection in Knee OA
A phase 2 trial of EP-104IAR (long-acting, fluticasone propionate) has shown 14 weeks of clinically meaningful pain relief in knee osteoarthritis (OA).
Ganglion cysts are thin walled cavities contain a viscous, mucinous fluid, arising in proximity to joint capsules/tendon sheaths but do not communicate with the joint. Most common w/ repetitive strain or overuse, trauma, or inflam. arthritis. Steroid injx dont… https://t.co/YWcIPGplvL https://t.co/KluiSUCZTt
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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.
The recombinant zoster vaccine (RZV; or "Shingrix") was FDA approved In 2017 for
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Trends in Early Undifferentiated PolyArthritis presentation. Over 3 eras (1998-2004-245 pts; 2005-10 266 pts; 2011-22 329 pts) many Sxs & Rx same. But Sxs duration 2.9 to 4.1mos, seropositivity 54 to 42%, Erosion score 18 to 9, mostly in Seroneg pts; Steroids incr 18 to 33%… https://t.co/AZfjqB4xGI https://t.co/GEwDWjccxl
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Genentech announced top line results of the REGENCY Phase III study of obinutuzumab (Gazyva) in lupus nephritis. 271 LN (class III or IV; +/- V) taking MMF & steroids were given placebo or OBIN for 76 wks. OBIN was superior @ complete renal resp at 76 wks… https://t.co/Um9du7fgxE https://t.co/RRWumnbTuy
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British Society Guidelines for Managing Behçet’s Disease
An exhaustive, full read guideline from the British Association of Dermatologists (BAD) and the British Society for Rheumatology (BSR) on the management and treatment of Behçet’s disease (BD) in 2024 has been published in Rheumatology.
This guideline provides up-to-date,
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I Can't Treat Ugly (9.20.2024)
Dr. Jack Cush reviews the news, journal articles and a new FDA approval for EGPA, this week on the Podcast.
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Mycophenolate in New-Onset SLE
How aggressively do you treat newly diagnosed new-onset systemic lupus erythematosus (SLE), or should you wait for organ involvement? A trial of early use of mycophenolate mofetil (MMF), in addition to prednisone and hydroxychloroquine, decreased severe flares and the development of renal
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1,717 Chinese rheumatologists (92% response) surveyed on Steroid use in RA. 60% admit to infrequent use of GC cotherapy. Bridging GC use was supported (35%), opposed (27%), but 38% were inconclusive & 67% said long-term low-dose GC use depends on the pt https://t.co/7qe1aRsZx8 https://t.co/D0RoYxPohY
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Increased Cardiovascular Events in Lupus
A New York surveillance registry (Manhattan Lupus Surveillance Program) estimates higher rates of cardiovascular events (CVE) among systemic lupus erythematosus (SLE) patients, especially amongst younger males, Hispanic/Latinos and non-Hispanic Black patients.
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Systemic Sclerosis Insights (9.13.2024)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.
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Systematic literature review IVIG in systemic sclerosis included 12 studies, 266 pts. A favorable effect was seen for skin thickening, MSK pain, GI Sxs, Steroid use, QOL. But less effect for pulmonary Dz, PFTs (stabilized?). Studies were not of high-quality… https://t.co/c3Xix9K2XK https://t.co/L3LKwegmkf
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Good Clinical Practice Recommendations on Glucocorticoid Withdrawal and Adrenal Insufficiency
The European Society of Endocrinology and Endocrine Society have jointly published a clinical guideline on the diagnosis and treatment of glucocorticoid-induced adrenal insufficiency,… https://t.co/GmQ5ypvqWP https://t.co/oab9qHpxSa
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Urticarial Vasculitis Overview
Urticarial vasculitis is rare and the causes often go undiagnosed. A Medscape recent overview highlights key features in the diagnosis and management of this rare disorder.
Urticarial vasculitis is often chronic, or recurrent, accompanied by a painful or burning sensation. The wheals or
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Retrospective observational study of 96 stable #SLE pts compared maintenance on HCQ vs belimumab. There were no significant differences in Flare rate (18% HCQ vs 8.3% BLM; p=0.47), damage index increase, SLEDAI, Pred dose or adverse events https://t.co/sVPMugSHn3 https://t.co/6bdel6Kvs9
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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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It takes >3-4 weeks of steroids (@ any dose >5 mg pred/d) to pose risk of adrenal insufficiency – Hence, Endocrine Society Guideline says short-term glucocorticoid therapy of <3-4 wks, irrespective of dose, DOES NOT require GC tapering https://t.co/o7tz1Am9pe https://t.co/CndfCYRApj
Dr. John Cush @RheumNow( View Tweet )
Running with Data (8.30.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com - including tips on steroids, MAS, and myositis testing.
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MDs: How long must you be on Pred 40 mg/d before you must slowly wean pred (vs stopping abruptly)?
Dr. John Cush @RheumNow( View Tweet )
Check out a NEW review on the dichotomy of #glucocorticosteroids treatment in #rheumaticdiseases by @maurizio_cutolo and team
👉https://t.co/6c08ucQlDN
👨🎓Glucocorticosteroids - a double-edged sword https://t.co/VdKlPzFpOb
Links:
@ReumatologiaJ @ReumatologiaJ( View Tweet )
RISE registry study shows Prednisone Rx before rheum consult ends up with more long-term Pred. 1,733 RA pts; 715 on GC (41% 0.5-2 mos before rheum care). mean GC use =157 d. GC before rheum care associated with longer GC use https://t.co/UpeK4hwIN0 https://t.co/F8cuoX0ACq
Links:
Dr. John Cush @RheumNow( View Tweet )
All in the Family (8.23.2024)
Dr. Jack Cush picks highlight reports from the past week on RheumNow.com, with reports on the challenge of lupus nephritis, perplexing skin issues, you don't know JAK (about Tyk) and the value of a good family history.
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Pulse Steroids with Tocilizumab in Giant Cell Arteritis
A pilot study assessed pulse methoprednisolone with weekly subcutaneous tocilizumab (TCZ) in patients with large vessel-GCA (LV-GCA) and showed that a sizeable minority will relapse after the TCZ is discontinued.
Metanalysis of 50 RCTs (3,231 pts w/ lupus nephritis (LN) related starting pred dose to rates of complete response (CR), serious infections, & death. PO pred 25 mg/D assoc w/ 20%, 3.2% & 0.2%, respectively. Pred 60 mg/day incr rates to 35%, 12% & 2.7% https://t.co/6FH9BWsmaz https://t.co/0cQPAIuvRw
Dr. John Cush @RheumNow( View Tweet )
CARRA Consensus Treatment for Refractory Juvenile Dermatomyositis
CARRA has developed consensus treatment plans for the use of biologic disease-modifying antirheumatic drugs (bDMARDs) in patients with refractory, moderately severe juvenile dermatomyositis. Juvenile dermatomyositis is the most common form of idiopathic, inflammatory myositis in childhood, with
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