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RheumNow Podcast – Mistakes with Steroids

Apr 08, 2021 10:37 pm

Dr Jack Cush gives his spin on this week's RheumNews and Rheum Research from

  1. Survey study of 1221 RA patients and 414 rheumatologists shows both believe that low-dose steroids (GCs) are very rapid and effective in RA control. Half patients reported having serious adverse events & 83% had safety concerns.

  2. Beijing study of 207 RA patients starting DMARD and steroids (GC) shows after 3 years only 59% D/C GC (mean was 24 mos). Odds of stopping GC were 10% @ 6mos, 27% @Yr1, 48% @Yr 2 and 59% at 3 years.

  3. Cox-2 inhibition (Celebrex 200 mg bid) added to standard chemoRx (FolFox) in pts w/ stage III colon cancer failed to improve survival at 3 yrs - DB, RCT vs placebo; 3 yrs Dz free survival was Celecoxib 76% vs PBO 73% (HR 0.89; 95% CI, 0.76-1.03; P = .12)

  4. Interesting case with unilateral sacroilitis - potential mimics include: Paget disease, diffuse idiopathic skeletal hyperostosis, sarcoidosis, infections [3], and also bone and hematologic tumors. What did this man have?

  5. Algorithm for the diagnostic approach of patients with joint pain - developed by PANLAR rheumatologists from 18 countries using a delphi method. Open read

  6. CDC updates its COVID Comorbid Dz list to include type 1 diabetes (& NIDDM), mod-severe asthma, liver Dz, dementia , stroke/cerebrovascular disease, HIV infxn, cystic fibrosis, obesity, substance use disorders (NOT ARTHRITIS, PSORIASIS)

  7. HLA-B27 status does not change the risk of COVID-19 in spondyloarthritis patients. Survey of 3435 SpA pts; shows 76% as HLA-B27 positive. COVID infx was the same between B27 Pos & Neg pts (1.5% vs 1.4%) and severity was also the same

  8. Another study suggests poorer outcomes in Rheum pts on Rituximab. French Cohort study of 1090 inflammatory rheumatic MSK pts -13% w/ severe COVID-19 & 8% who died –THE  63 RTX pts had more severe disease, longer hosp stays & more death (21% vs 7%)

  9. Rituximab in Systemic Sclerosis?

  10. Rheumatology Care Derailed by COVID-19

The author has no conflicts of interest to disclose related to this subject

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