Clinicians should not rely on glucocorticoids as a first-line treatment of SARD-ILD in patients with systemic sclerosis, according to a strong recommendation in a new ILD treatment guideline from the ACR and CHEST. The guideline is one of two addressing the screening, monitoring and treatment of patients with interstitial lung disease (ILD) secondary to systemic autoimmune rheumatic diseases (SARDs).
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CAR-T Cell Therapy in Autoimmune Disease: The Next Frontier
Chimeric antigen receptor (CAR) T cell therapy has the potential to fundamentally shift the treatment of autoimmune disease. During his presentation at EULAR 2024, Georg Schett, MD, provided an overview of this treatment process and described the promising findings of the latest research.
Telehealth Triage Study Seeks to Close Gaps in Care
Reducing the time to diagnosis and initiation of appropriate treatment is paramount to intercept inflammatory damage in patients at the onset of rheumatic disease. But those targets can be delayed by provider shortages and other barriers to care. Since last June, Remission Medical, a virtual rheumatology clinic, has been partnering with Mayo Clinic to find…
Case Report: Persistent Pruritic Plaques in Adult-Onset Still’s Disease
Adult-onset Still’s disease (AOSD) is a systemic autoinflammatory disorder characterized by persistent fever at regular intervals, arthralgias or arthritis, rash, sore throat and neutrophilic leukocytosis.1,2 Significant elevation in ferritin levels is characteristic and tends to correlate with disease activity. Additional clinical features may include myalgias, lymphadenopathy, hepatosplenomegaly, serositis, myocarditis, abnormal liver function tests and development…
Polymyalgia Rheumatica: New Tricks for an Old Disease
Originally posted Feb. 13, 2023; reposted in conjunction with publication of the PMR supplement to the February 2024 issue of The Rheumatologist. PHILADELPHIA—Polymyalgia rheumatica (PMR) is a chronic inflammatory condition that almost exclusively affects individuals older than 50.1 First described in 1888, PMR has been a recognized rheumatic disease since at least 1957. Diagnosing the…
Study Assesses Sarilumab for Polymyalgia Rheumatica
In an ACR Convergence 2022 session, Robert Spiera, MD, director of the Scleroderma, Vasculitis, and Myositis Center at the Hospital for Special Surgery, New York City, discussed the use of sarilumab as a potential glucocorticoid-sparing therapy in a phase 3 study in patients with treatment-refractory polymyalgia rheumatica (PMR), one of the most common inflammatory diseases…
How to Treat Refractory Polymyalgia Rheumatica
Patients with polymyalgia rheumatica (PMR) who had relapsed while tapering glucocorticoid therapy were more likely to achieve sustained remission at one year and have a lower glucocorticoid exposure if they were treated with sarilumab (Kevzara) plus a rapid, 14-week glucocorticoid taper than if they received placebo plus a standard, 52-week glucocorticoid taper. This is according…
Study: Most Patients with PMR Aren’t Getting Steroid-Sparing Agents in First 2 Years
A minority of patients with polymyalgia rheumatica (PMR) who were new to rheumatology practice were prescribed steroid-sparing agents through two years of follow-up. This is according to a large, U.S.-based cohort study, published in Arthritis Care & Research, which also found that nearly two-thirds of the patients remained on glucocorticoids beyond one year.1 “Our study…
How Prevalent Is Subclinical Giant Cell Arteritis in Polymyalgia Rheumatica?
Background/Purpose It has been reported that 20–50% of patients with polymyalgia rheumatica (PMR) have subclinical giant cell arteritis (GCA). The natural history of ultrasound-defined subclinical GCA in PMR is not known. Methods Twenty-five newly diagnosed PMR patients who met a clinical diagnosis for PMR, verified by two rheumatologists, were examined by ultrasound. All six branches…
Pharmacokinetic Modeling & Efficacy Extrapolation: FDA Takes New Approaches to Drug Approvals
An array of new and expanded indications of therapeutics for rheumatic disease last year relied on pharmacokinetic modeling for intravenous dosing and efficacy extrapolation for pediatric populations.
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