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DORIS - Defining Remission in Lupus

Nov 29, 2021

Proponents of treat to target in systemic lupus erythematosus (SLE) have all agreed that "remission" should be the goal, but defining remission may be tricky in SLE.  A SLE Definitions Of Remission (DORIS)Task Force was convened in 2015 and first published their work in 2016. Now the 2021

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Giant Cell Arteritis Novel Treatment Options

Giant cell arteritis is associated with significant treatment related morbidity due to the dependence on glucocorticoids as a treatment option. After sixty years of therapeutic stagnation, these are exciting times in the management of GCA. At this year's ACR Convergence meeting, encouraging data

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Long Term Steroid Use in RA - Matters of the Heart: Dr. Mrinalini Dey ( @DrMiniDey) discusses abstract #1428 presented at the #ACR21 annual meeting.https://t.co/E6RSlPAuRT https://t.co/QBhKD855aH
Dr. John Cush @RheumNow( View Tweet )
Nov 22, 2021
GLORIA Study - Is Prednisone Harmful in Elder RA? The GLORIA study (ABST#1678) was a pragmatic, blinded placebo-controlled randomized trial where they assessed whether prednisolone (vs. placebo) use would alter clinical outcomes over 2 years.https://t.co/eKXjiDpHlc https://t.co/JtCgc1uZnE
Dr. John Cush @RheumNow( View Tweet )
Nov 19, 2021
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Top vasculitis takeaways from ACR 2021

There were several hot topics at ACR21. Here I concentrate on top abstracts in vasculitis. 

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GLORIA Study - Is Prednisone Harmful in Elder RA?

Nov 17, 2021

The GLORIA study (ABST# 1678) was a pragmatic, blinded placebo-controlled randomized trial from Dr. Martin Boers and colleagues where they assessed whether prednisolone (vs. placebo) use would alter clinical outcomes over 2 years.



A total of 451 elder patients with established RA

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RheumNow Podcast - ACR 2021 Rehash (the good stuff..)

Nov 12, 2021

The ACR 2021 meeting has concluded. Dr. Jack Cush recounts a few more great abstracts from this past week’s virtual meeting.

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Emapalumab for the treatment of macrophage activation syndrome

Macrophage activation syndrome (MAS) is a term commonly used by rheumatologists to describe a potentially life-threatening complication of systemic inflammatory disorders, most commonly occurring in people with systemic juvenile idiopathic arthritis (sJIA) and systemic lupus erythematosus (

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Another study linking long term GC and CV risk in RA! Medicare data >65yo 130000+ pts 1-year incidence CV ⬆️ as follows: 📍Dose ≤5mg 1.4% 📍Dose 5-10mg 1.7% 📍Dose >10mg 1.9% Not replicated in younger pts (Optum data) #ACR21 #Abst1915 @RheumNow https://t.co/DLXdfvfiBW
Aurelie Najm @AurelieRheumo( View Tweet )
Nov 09, 2021
Once again #steroids are bad in #RheumatoidArthritis from 2 large admin databases in age >65 in Medicare data, not in younger pts -Optum data. Clear dose response #ACR21 #ACRBest @RheumNow abst#1915 https://t.co/XL93jty7C9
Nov 09, 2021
#ACR21 Abs#1915 👉🏼Chronic steroid use in older adults on stable DMARD therapy assoc w/ ⬆️CV risk 👉🏼Risk even present among older adults receiving low dose ≤5mg/day 👉🏼Larger studies needed in younger healthier adults @RheumNow https://t.co/Lsj5YBz7IG
Mrinalini Dey @DrMiniDey( View Tweet )
Nov 09, 2021
Long-term low dose glucocorticoid use associated ⬆️cardiovascular risk. Clear effect in Medicare population (older), not evident in Optum (younger). Dose dependent. Abstr#1915 #ACR21 @RheumNow https://t.co/oFet3Hhsfo
Richard Conway @RichardPAConway( View Tweet )
Nov 09, 2021
Fibromyalgianess Glucocorticoid Persistence in RA Patients: Dr. Sheila Reyes ( @RHEUMarampa) discusses abstract #0120 presented at the #ACR21 annual meeting.https://t.co/9yOM5rSARv https://t.co/Gq2YxbxkmM
Dr. John Cush @RheumNow( View Tweet )
Nov 09, 2021
Glory to GLORIA trial? Low dose prednisone 2mg in active RA>65yrs, N=451 All Standard care. in 2yrs, ~40% drop out- same in each grp Better RA control but NNH 9.5 w steroids, mostly non severe infections. So, prednisone debate in RA continues #ACR21 @RheumNow #ACRBest abst#1678 https://t.co/emOaYSjYAa
Nov 09, 2021
Sub-analysis of ICHIBAN study looking at adverse events in tocilizumab treated patients with/without steroids. Steroids associated with small increase in adverse events across board. Abstr#1693 #ACR21 @RheumNow https://t.co/ldiovirKpo
Richard Conway @RichardPAConway( View Tweet )
Nov 09, 2021
What is the effect of long-term #steroid use on major adverse #cardiovascular events (MACE)? Find out in my video summary of abstract #1428 which was presented yesterday by @BethIWallace Read here👉🏼https://t.co/fCM3m04ruSWatch here👉🏼https://t.co/TLerQT7XnG#ACR21 @RheumNow

Mrinalini Dey @DrMiniDey( View Tweet )

Nov 09, 2021
Are there people looking at steroid-sparing therapy as irAE treatment or prevention? @CCalabreseDO: are there ever #ACR21 irAE Study Group @RheumNow (also @NAbdelwahabMD @ReidMDMPH on stage) https://t.co/CLmNaLB68O
Nov 09, 2021
ACR Best

ACR21 Best Abstracts We Saw - Day 3 (Monday)

Nov 08, 2021

The third day of ACR 2021 took a big leap in online content.  Here is a compilation (with links) of presentations were the “ACRBest” as seen by our RheumNow faculty. 

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Dr. Furie thinks that pulse IV steroids are more effective than oral high dose steroids. If you use pulse IV, you can then use a lower oral dose of prednisone w/faster taper. Will he mandate pulse IV steroids w/his next trial? ...long pause.. No. #ACR21 @rheumnow

TheDaoIndex @KDAO2011( View Tweet )

Nov 08, 2021
#PJP prophylaxis debate at #lupus hub if on #prednisone + immune suppression. #SLE has ⤴️septra side effects. Don’t know right answer. NNT v NNH is unknown. I don’t use it in #SLE. @RheumNow #ACR21 8M212
Nov 08, 2021
#ILD in #rheumatic diseases. When to use #glucocorticoids and immune suppressive sand anti fibrotic. V clear but harder in real world! @RheumNow #ACR21 #ACRBest https://t.co/R4V5ZggRsu
Nov 08, 2021
Steroids can cause co-morbidities which increase CV risk, but can PNL directly increase CV event (MACE) risk in RA? 30d PNL➡️15% increase in MACE in next 30d (independent of underlying CV risk, RA dx activity) PNL actively confers risk! @BethIWallace #ACR21 ABST1428 @RheumNow https://t.co/cuL69n7cx3
Nov 08, 2021
Plenary Abs#1428 #ACR21 👉🏼Long-term #steroid use is common in RA incl in pts with high risk of #MACE 👉🏼30days of steroids ➡️ 15% increased odds of MACE @RheumNowhttps://t.co/fCM3m04ruS https://t.co/FWGmAatYu5
Mrinalini Dey @DrMiniDey( View Tweet )
Nov 08, 2021
26K Veterans data with RA #ACR21 plenary abst#1428 30 days on glucocorticoids - ⬆️15% odds of Major Adverse Cardiovascular events @RheumNow @BethIWallace https://t.co/BOram4o2rp
Bella Mehta @bella_mehta( View Tweet )
Nov 08, 2021
Role of GC on MACE in RA: US database analysis 26000+pts 23% on GC >90d/6mo Each 30days of GC dispensed ⏭15% increase in odds of MACE in the following 6month period! Adjustment on several confounders but not disease activity. #Abts1428 #ACR21 @RheumNow https://t.co/prdA7D5fLz https://t.co/F3wCcRAfuf
Aurelie Najm @AurelieRheumo( View Tweet )
Nov 08, 2021
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