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Corticosteroids, An Issue of Rheumatic Disease Clinics of North America, E-Book

Corticosteroids, An Issue of Rheumatic Disease Clinics of North America, E-Book

Marcy B. Bolster

(2016)

Additional Information

Book Details

Abstract

Corticosteroids represent the most important and frequently used class of anti-inflammatory and immunosuppressant agents in the management of many rheumatological conditions. Included in this issue will be articles on the following topics: Glucocorticoid use in intra-articular and soft tissue injections, corticosteroids and osteoporosis, corticosteroids in lupus, ANCA associated vasculitis, and many more!

Table of Contents

Section Title Page Action Price
Front Cover Cover
Corticosteroids\r i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
EDITOR iii
AUTHORS iii
Contents vii
Foreword: Corticosteroids \r vii
Preface: Corticosteroids: Friends and Foes\r vii
The History of Cortisone Discovery and Development\r vii
Corticosteroids: Mechanisms of Action in Health and Disease\r vii
Glucocorticoids and Rheumatoid Arthritis\r vii
Corticosteroids in Lupus\r viii
Corticosteroids in Lupus Nephritis and Central Nervous System Lupus\r viii
Glucocorticoids for Management of Polymyalgia Rheumatica and Giant Cell Arteritis\r viii
Corticosteroids in Antineutrophil Cytoplasmic Antibody–Associated Vasculitis\r viii
Corticosteroids in Myositis and Scleroderma\r ix
Corticosteroids in Sarcoidosis\r ix
Corticosteroids for Pain of Spinal Origin: Epidural and Intraarticular Administration\r ix
Infection Risk and Safety of Corticosteroid Use\r ix
Glucocorticoid-induced Osteoporosis\r x
RHEUMATIC DISEASE CLINICS\rOF NORTH AMERICA\r xi
FORTHCOMING ISSUES xi
May 2016 xi
August 2016 xi
November 2016 xi
RECENT ISSUES xi
November 2015 xi
August 2015 xi
May 2015 xi
Foreword: Corticosteroids \r xiii
Preface: Corticosteroids: Friends and Foes \r xv
The History of Cortisone Discovery and Development 1
Key points 1
INTRODUCTION 1
PHILIP SHOWALTER HENCH 2
EDWARD CHARLES KENDALL 4
WORLD WAR II 4
MRS G 5
THE STORY BREAKS 5
THE NOBEL PRIZE 7
AFTERMATH 7
THE EMPIRE STRIKES BACK 9
EPILOGUE 10
THE LEGACY OF CORTICOSTEROIDS 11
REFERENCES 12
Corticosteroids 15
Key points 15
INTRODUCTION 15
GLUCOCORTICOID SYNTHESIS, SECRETION, AND BIOAVAILABILITY 16
GLUCOCORTICOID RECEPTOR 18
MECHANISMS OF GLUCOCORTICOID ACTION 18
Genomic Actions of Glucocorticoids 18
Nongenomic Actions of Glucocorticoids 21
GLUCOCORTICOID RECEPTOR HETEROGENEITY 21
Glucocorticoid Receptor Splice Variants 21
Glucocorticoid Receptor Translational Isoforms 23
Posttranslational Modifications of Glucocorticoid Receptor 24
Glucocorticoid Receptor Polymorphisms 25
SUMMARY AND FUTURE CONSIDERATIONS 26
REFERENCES 26
Glucocorticoids and Rheumatoid Arthritis 33
Key points 33
INTRODUCTION 33
CLINICAL APPLICATIONS IN RHEUMATOID ARTHRITIS 34
Inflammation Under Control 34
Pain Relief and Structural Progression 34
Fatigue, Anxiety, and Depression 34
DOSING IN RHEUMATOID ARTHRITIS 35
Equivalents of Prednisone 35
ADMINISTRATION IN RHEUMATOID ARTHRITIS 36
Systemic 36
Oral 36
Parenteral 36
Intra-articular 37
SIDE EFFECTS 37
Patient Education 37
Minimizing glucocorticoid side effects 38
Osteoporosis and Fractures 38
Other Musculoskeletal Adverse Events 38
Endocrine and Metabolic Adverse Events 38
Glucose metabolism and diabetes 38
Weight gain 39
Hypothalamic-pituitary-adrenal axis suppression 39
Cardiovascular Risk Factors and Atherosclerosis 40
Infections 40
Renal Dysfunction 40
Dermatologic Side Effects 41
Ophthalmologic Side Effects 41
Gastrointestinal Side Effects 41
Neuropsychological Side Effects 42
DRUG-DRUG INTERACTIONS 42
FUTURE CONSIDERATIONS 43
SUMMARY 43
REFERENCES 43
Corticosteroids in Lupus 47
Key points 47
INTRODUCTION 47
CLINICAL APPLICATIONS 48
General 48
Mucocutaneous 48
Musculoskeletal 49
Hematologic 49
Cardiac 49
Pulmonary 49
Gastrointestinal 49
Ophthalmologic 49
Nephritis and Neuropsychiatric 52
Pregnancy and Lactation 52
Corticosteroids in Lupus Nephritis and Central Nervous System Lupus 63
Key points 63
INTRODUCTION 63
EPIDEMIOLOGY OF LUPUS NEPHRITIS 64
EVALUATION OF LUPUS NEPHRITIS 64
TREATMENT GOALS FOR LUPUS NEPHRITIS 64
PROLIFERATIVE LUPUS NEPHRITIS INDUCTION THERAPY 64
PROLIFERATIVE LUPUS NEPHRITIS MAINTENANCE THERAPY 65
CHALLENGING CURRENT CORTICOSTEROID PRACTICES 66
TAPERING OF CORTICOSTEROIDS 66
EPIDEMIOLOGY OF CENTRAL NERVOUS SYSTEM LUPUS 66
EVALUATION OF CENTRAL NERVOUS SYSTEM LUPUS 67
COMMON CENTRAL NERVOUS SYSTEM FEATURES IN PATIENTS WITH LUPUS 67
FEATURES OF LESS FREQUENT CENTRAL NERVOUS SYSTEM LUPUS EVENTS 68
TREATMENT STRATEGIES FOR CENTRAL NERVOUS SYSTEM LUPUS 68
IMMUNOSUPPRESSION FOR CENTRAL NERVOUS SYSTEM LUPUS REFRACTORY TO CORTICOSTEROIDS 69
ADVERSE EFFECTS OF CORTICOSTEROIDS 69
SUMMARY 70
REFERENCES 70
Glucocorticoids for Management of Polymyalgia Rheumatica and Giant Cell Arteritis 75
Key points 75
INTRODUCTION 76
CLINICAL FEATURES 76
MANAGEMENT 78
GLUCOCORTICOIDS FOR TREATMENT OF POLYMYALGIA RHEUMATICA AND GIANT CELL ARTERITIS 79
MECHANISMS OF GLUCOCORTICOID ACTIONS 79
WHY DOES CLINICAL EFFICACY OF GLUCOCORTICOID THERAPY VARY AMONG DIFFERENT PATIENTS? 81
ADVERSE EFFECTS OF GLUCOCORTICOIDS 81
CLINICAL ASPECTS OF THERAPY WITH GLUCOCORTICOIDS IN POLYMYALGIA RHEUMATICA AND GIANT CELL ARTERITIS 81
Polymyalgia Rheumatica 82
Giant Cell Arteritis 84
NONSTEROIDAL ANTIINFLAMMATORY DRUGS AND ANALGESICS IN POLYMYALGIA RHEUMATICA AND GIANT CELL ARTERITIS 85
GLUCOCORTICOID-SPARING AGENTS IN POLYMYALGIA RHEUMATICA AND GIANT CELL ARTERITIS 85
Nonbiological Agents 85
Biological Agents 86
ASPIRIN USE IN GIANT CELL ARTERITIS 86
MANAGEMENT OF GLUCOCORTICOID-RELATED COMPLICATIONS IN POLYMYALGIA RHEUMATICA AND GIANT CELL ARTERITIS 86
SUMMARY 86
REFERENCES 87
Corticosteroids in Antineutrophil Cytoplasmic Antibody–Associated Vasculitis 91
Key points 91
INTRODUCTION 91
REMISSION INDUCTION THERAPY 92
Intravenous Glucocorticoids 92
Oral Glucocorticoids 93
MAINTENANCE THERAPY 95
TREATMENT OF RELAPSES 96
LOCAL GLUCOCORTICOIDS 96
FUTURE CONSIDERATIONS 97
SUMMARY 98
REFERENCES 98
Corticosteroids in Myositis and Scleroderma 103
Key points 103
IDIOPATHIC INFLAMMATORY MYOPATHIES 103
Background and Clinical Manifestations 103
Corticosteroids in Sarcoidosis 119
Key points 119
INTRODUCTION 119
INDICATIONS TO TREAT SARCOIDOSIS 120
GENERAL APPROACH TO THE TREATMENT OF SARCOIDOSIS WITH CORTICOSTEROIDS 122
Issues of Dose 122
Issues of Duration 122
Issues of When to Add Additional Agents to Corticosteroids 123
CORTICOSTEROID THERAPY FOR SPECIFIC FORMS OF SARCOIDOSIS 124
Pulmonary Sarcoidosis 124
Cardiac Sarcoidosis 125
Skin Sarcoidosis 126
Eye Sarcoidosis 127
Neurologic 128
Musculoskeletal Involvement 129
Other Organs 130
SUMMARY 130
REFERENCES 130
Corticosteroids for Pain of Spinal Origin 137
Key points 137
INTRODUCTION 137
BACKGROUND 138
THERAPEUTIC RATIONALE 140
CLINICAL INDICATIONS 141
ANATOMIC TARGETS FOR CORTICOSTEROID INJECTION 142
EPIDURAL STEROID INJECTION 143
Epidural Steroid Injection: Three Approaches 145
Epidural Steroid Injection: Efficacy 146
Epidural Steroid Injection: Dosage 147
Epidural Steroid Injection: Fluoroscopy 147
LOCAL INJECTION FOR CHRONIC LOW BACK PAIN SYNDROMES ATTRIBUTED TO THE LUMBAR FACET JOINTS 147
SACROILIAC JOINT INJECTION 148
Comment: Area of Overlap – Spinal Injections into Facet/Sacroiliac Joints Related to Discussion in Other Chapters About Int ... 148
Complications 148
SIDE EFFECTS OF THE STEROIDS 149
Complications: Dosage 149
Complications: Steroid Formulation 149
Complications: Needle Placement 150
ORAL STEROIDS 150
Contraindications 150
REFERENCES 151
Infection Risk and Safety of Corticosteroid Use 157
Key points 157
INTRODUCTION 157
INFECTION IN RHEUMATIC DISEASES AND CORTICOSTEROIDS 158
RANDOMIZED CONTROLLED TRIALS 159
OBSERVATIONAL STUDIES 159
OPPORTUNISTIC INFECTIONS 162
PNEUMOCYSTIS JIROVECI PNEUMONIA 162
Herpes Zoster 166
Strongyloidiasis 167
Tuberculosis 167
VACCINATION AND OTHER PREVENTION STRATEGIES 168
Pneumocystis jiroveci Pneumonia 168
Herpes Zoster 169
Tuberculosis 169
SUMMARY 170
REFERENCES 171
Glucocorticoid-induced Osteoporosis 177
Key points 177
INTRODUCTION 177
GLUCOCORTICOID EFFECTS ON BONE 178
EPIDEMIOLOGY 178
DIAGNOSIS/IDENTIFYING PATIENTS AT RISK 179
Bone Mineral Density Measurement 179
FRAX 179
Other Testing Strategies 180
PREVENTION AND TREATMENT 180
Lifestyle Measures and Assessment 180
Calcium and Vitamin D 181
Bisphosphonates 182
Teriparatide 183
Denosumab 183
Raloxifene 184
Percutaneous Vertebroplasty 184
International Guidelines for Glucocorticoid-induced Osteoporosis 184
Postmenopausal women and men greater than or equal to 50 years of age 184
Premenopausal women and men aged less than 50 184
SUMMARY 185
ACKNOWLEDGMENTS 186
REFERENCES 186
Index 191