Drugs

Which treatments may be used in Takayasu Arteritis as adjuncts to glucocorticoids? The best evidence base and clinical experience exists for methotrexate. The use of tocilizumab in relapsing TA has been investigated, although data supporting its use in TA are less robust than in GCA. Leflunomide, mycophenolate mofetil, azathioprine, ustekinumab, and infliximab have also been …

Which treatments may be used in Takayasu Arteritis as adjuncts to glucocorticoids Read More »

Will treatment with corticosteroids reduce the yield of a temporal artery biopsy or imaging in Giant Cell Arteritis? Studies have shown that biopsies often show findings typical for arteritis after more than 14 days of corticosteroid therapy, although a biopsy should ideally be obtained within 7 days of starting treatment. Steroids should not alter the …

Will treatment with corticosteroids reduce the yield of a temporal artery biopsy or imaging in Giant Cell Arteritis Read More »

How is tocilizumab used in Giant Cell Arteritis? The role of tocilizumab in routine practice is actively evolving. Many experts use tocilizumab (162 mg subcutaneous weekly) as part of the initial therapy along with glucocorticoid in order to more rapidly taper the prednisone. Others reserve its use for patients with refractory or recurrent disease or …

How is tocilizumab used in Giant Cell Arteritis Read More »

Which steroid sparing therapies are used in Giant Cell Arteritis? Methotrexate has long been used as a steroid-sparing therapy in GCA, although evidence supporting its use is mixed with regard to its effectiveness. Nonetheless, methotrexate is utilized in patients with significant steroid-related side effects, diabetes, or a relapsing course with prolonged need for steroids. Based …

Which steroid sparing therapies are used in Giant Cell Arteritis Read More »

What steroid sparing disease modifying antirheumatic drugs and biologics can be used in Polymyalgia Rheumatica? In patients with steroid-dependent PMR, MTX (10–20 mg/week) is reported to facilitate tapering of steroids. Azathioprine may also serve as a steroid-sparing agent. In 2016, Lally et al reported tocilizumab to be an effective treatment, highlighting the prominent role for …

What steroid sparing disease modifying antirheumatic drugs and biologics can be used in Polymyalgia Rheumatica Read More »

How long should prednisone be continued in Polymyalgia Rheumatica? Tapering of the prednisone is based on the patient’s clinical response. PMR symptoms and ESR/CRP are the most reliable parameters to follow. The CRP normalizes more quickly than the ESR, which should decline to normal within 1 month. Failure to normalize these acute-phase reactants should prompt …

How long should prednisone be continued in Polymyalgia Rheumatica Read More »

What therapies have been used successfully for the non thrombotic manifestations of APS? • Immune-mediated thrombocytopenia (<20,000/mm 3 ): glucocorticoids with or without IVIG. Second-line therapy: traditional immunosuppressives, rituximab. Try to avoid splenectomy due to operative clot risk. • Immune-mediated hemolytic anemia: same as thrombocytopenia. • Acute renal failure due to thrombotic microangiopathy: plasma exchange. • Chronic ischemic nephropathy due to …

What therapies have been used successfully for the non thrombotic manifestations of APS Read More »