Steroids, Adrenal Insufficiency, & Toxicity

0:00
0:52 Early use of glucocorticoids in vasculitis.
2:11 The Pexivas Trial.
3:08 The ADVOCATE Phase III Trial.
4:08 Targeted therapy in Giant Cell Arteritis.
5:16 Glucocorticoids: The best/worst medication.
8:17 Are corticosteroids always necessary?
12:22 Adrenal insufficiency: why we taper so slowly.
15:11 Withdrawal symptoms vs. adrenal insufficiency.
19:15 Can adrenal function be tested before you get to zero milligrams of prednisone?
20:24 Does taking prednisone result in an elevated lipid profile?
21:08 What is the eligibility to be on Avocopan if they have been on steroids for a long time?
23:11 What options exist if the adrenals no longer work?
24:51 What is considered a high dose of steroids?
26:26 What about the effect of steroids on bones and a loss of calcium?
28:38 What is considered “long-term use of steroids?”
29:34 Why do steroids cause weight gain?
30:13 What is the connection between fatigue and steroids?
31:35 Could you elaborate when you say that we’re getting closer to not needing steroids? Is this because of new medications?
Steroids, Adrenal Insufficiency, & Toxicity
Recorded July 2023
Dr. Villa-Forte and Dr. Kinanah Yaseen review the purpose and necessity of corticosteroids, side effects, tapering doses, and withdrawal symptoms versus adrenal insufficiency. They discuss treatment for vasculitis without steroids.
View slide presentation: tinyurl.com/3nr3hs7u
Expand your knowledge of vasculitis. Visit the Vasculitis Foundation website at: www.vasculitisfoundation.org/

[@andreamartin8358]

Thank you for posting this! As a GCA patient, you answered questions that I have been thinking about.

[@vasculitisfoundation]

So glad you found this helpful. You can find even more information about GCA on our website www.vasculitisfoundation.org/education/vasculitis-types/giant-cell-arteritis/

[@SharpLife4]

Can you explain if Actremra actually reduced inflammation or masks it and the inflammation is still there. I ask cause my wife crp is almost or close to normal but she had an ulceration abscess that showed high neutrophil inflammation but her blood work did not indicated any inflammation. She was on low dose steroid azathioprine and Actremra weekly injections wbc normal. Crp normal. Ferritin normal. Nothing went up or down when infection was treated. So now she wonders if she could have inflammation on her arteries still and it won’t be seen cause her rheum keeps saying crp is fine. Blood work fine. But has many symptoms. She also has severe shoulder pain on one side and cause is to be determined. Rheum said prob not vasculitis cause blood work fine. But again it was fine when she had a massive ulcerating wound. Her arm pain is so bad down her forearm. In Canada we can’t get mris urgently except for brain and stroke. Her disease so far only affects her carotids

[@vasculitisfoundation]

We are so sorry to hear about your wife. How frustrating to have severe pain and an abscess but feel like you are not getting answers as to what is causing them. As to your question as to whether or not Actemra masks inflammation, I don't have the knowledge or expertise to answer that question. Here is a link to the manufacturer's explanation of how Actemra targets the immune system on their patient website www.actemra.com/gca/considerations/how-it-works.html#:~:text=ACTEMRA%20is%20designed%20to%20block,it%20works%20in%20the%20body. We have a playlist of GCA videos including videos on treatments (such as Actemra). Here is a link to the playlist of those videos ua-cam.com/play/PLr6Bwau6uSmuggeIfFje-4xcOzwQ-RQ0Q.html
You can always find information on our website, including information about virtual support groups and other resources www.vasculitisfoundation.org/

[@trafficjon400]

Steroid strong Dexamethisone saves lives from 10 days to months but the patient has more suffering coming from induced sickness and wishes to rid the destruction and the induced cause of a new painful death.