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Reducing the Toxicity of Long-Term Glucocorticoid Treatment in Large Vessel Vasculitis

PURPOSE: While glucocorticoids (GCs) are effective in large vessel vasculitis (LVV), they may cause serious adverse events (AEs), especially if taken for longer durations and at higher doses. Unfortunately, patients suffering from LVV often need long-term treatment with GCs; therefore, toxicity need...

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Autores principales: Palmowski, Andriko, Buttgereit, Frank
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7550368/
https://www.ncbi.nlm.nih.gov/pubmed/33047263
http://dx.doi.org/10.1007/s11926-020-00961-0
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author Palmowski, Andriko
Buttgereit, Frank
author_facet Palmowski, Andriko
Buttgereit, Frank
author_sort Palmowski, Andriko
collection PubMed
description PURPOSE: While glucocorticoids (GCs) are effective in large vessel vasculitis (LVV), they may cause serious adverse events (AEs), especially if taken for longer durations and at higher doses. Unfortunately, patients suffering from LVV often need long-term treatment with GCs; therefore, toxicity needs to be expected and countered. RECENT FINDINGS: GCs remain the mainstay of therapy for both giant cell arteritis and Takayasu arteritis. In order to minimize their toxicity, the following strategies should be considered: GC tapering, administration of conventional synthetic (e.g., methotrexate) or biologic (e.g., tocilizumab) GC-sparing agents, as well as monitoring, prophylaxis, and treatment of GC-related AEs. Several drugs are currently under investigation to expand the armamentarium for the treatment of LVV. SUMMARY: GC treatment in LVV is effective but associated with toxicity. Strategies to minimize this toxicity should be applied when treating patients suffering from LVV.
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spelling pubmed-75503682020-10-19 Reducing the Toxicity of Long-Term Glucocorticoid Treatment in Large Vessel Vasculitis Palmowski, Andriko Buttgereit, Frank Curr Rheumatol Rep Recent Advances in Large Vessel Vasculitis ( C Dejaco and C Duftner, Section Editors) PURPOSE: While glucocorticoids (GCs) are effective in large vessel vasculitis (LVV), they may cause serious adverse events (AEs), especially if taken for longer durations and at higher doses. Unfortunately, patients suffering from LVV often need long-term treatment with GCs; therefore, toxicity needs to be expected and countered. RECENT FINDINGS: GCs remain the mainstay of therapy for both giant cell arteritis and Takayasu arteritis. In order to minimize their toxicity, the following strategies should be considered: GC tapering, administration of conventional synthetic (e.g., methotrexate) or biologic (e.g., tocilizumab) GC-sparing agents, as well as monitoring, prophylaxis, and treatment of GC-related AEs. Several drugs are currently under investigation to expand the armamentarium for the treatment of LVV. SUMMARY: GC treatment in LVV is effective but associated with toxicity. Strategies to minimize this toxicity should be applied when treating patients suffering from LVV. Springer US 2020-10-12 2020 /pmc/articles/PMC7550368/ /pubmed/33047263 http://dx.doi.org/10.1007/s11926-020-00961-0 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Recent Advances in Large Vessel Vasculitis ( C Dejaco and C Duftner, Section Editors)
Palmowski, Andriko
Buttgereit, Frank
Reducing the Toxicity of Long-Term Glucocorticoid Treatment in Large Vessel Vasculitis
title Reducing the Toxicity of Long-Term Glucocorticoid Treatment in Large Vessel Vasculitis
title_full Reducing the Toxicity of Long-Term Glucocorticoid Treatment in Large Vessel Vasculitis
title_fullStr Reducing the Toxicity of Long-Term Glucocorticoid Treatment in Large Vessel Vasculitis
title_full_unstemmed Reducing the Toxicity of Long-Term Glucocorticoid Treatment in Large Vessel Vasculitis
title_short Reducing the Toxicity of Long-Term Glucocorticoid Treatment in Large Vessel Vasculitis
title_sort reducing the toxicity of long-term glucocorticoid treatment in large vessel vasculitis
topic Recent Advances in Large Vessel Vasculitis ( C Dejaco and C Duftner, Section Editors)
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7550368/
https://www.ncbi.nlm.nih.gov/pubmed/33047263
http://dx.doi.org/10.1007/s11926-020-00961-0
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