2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/2iy5wruuedsh6.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/00yc7rcvua6a7.js","/_next/static/immutable/chunks/37ktb71aq3480.js","/_next/static/immutable/chunks/2d50b-7eu4558.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/2d6noqpp6ehas.js","/_next/static/immutable/chunks/1sx186c93bpzg.js","/_next/static/immutable/chunks/3dc-1n866s65i.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2w1bvggzb0ga8.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T43c,Among the 112 patients (median [range] age, 69 [39-79] years; 111 [99%] male), skin involvement was common (93 [83%]), and the most frequent presenting feature of disease (68 [61%]). Of 64 histopathologic reports available from 60 patients, predominant skin histopathologic findings were leukocytoclastic vasculitis (23 [36%]), neutrophilic dermatosis (22 [34%]), and perivascular dermatitis (19 [30%]). Distinct pathogenic genetic variants were associated with specific cutaneous manifestations. The p.Met41Leu variant was most frequently associated with neutrophilic dermal infiltrates (14 of 17 patients [82%]), often resembling histiocytoid Sweet syndrome. In contrast, the p.Met41Val variant was associated with vasculitic lesions (11 of 20 patients [55%]) with a mixed leukocytic infiltrate (17 of 20 patients [85%]). Oral prednisone improved skin manifestations in 67 of 73 patients (92%). Patients with VEXAS treated with anakinra frequently developed severe injection-site reactions (12 of 16 [75%]), including ulceration (2 of 12 [17%]) and abscess formation (1 of 12 [8%]).31:T946,VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome is a newly defined genetic disease with an estimated prevalence of 1 in 4269 men older than 50 years and is marked by systemic inflammation, progressive bone marrow failure, and inflammatory cutaneous manifestations. To define the spectrum of cutaneous manifestations in VEXAS syndrome and the association of these findings with clinical, genetic, and histological features. This observational cohort study included data from 112 patients who were diagnosed with VEXAS-defining genetic variants in UBA1 between 2019 and 2023. Data were collected from medical record review or from patients with VEXAS directly evaluated at the National Institutes of Health in Bethesda, Maryland. To define the spectrum of cutaneous manifestations in VEXAS in association with genetic, histological, and other clinical findings. A secondary outcome was cutaneous response to treatment in VEXAS. Among the 112 patients (median [range] age, 69 [39-79] years; 111 [99%] male), skin involvement was common (93 [83%]), and the most frequent presenting feature of disease (68 [61%]). Of 64 histopathologic reports available from 60 patients, predominant skin histopathologic findings were leukocytoclastic vasculitis (23 [36%]), neutrophilic dermatosis (22 [34%]), and perivascular dermatitis (19 [30%]). Distinct pathogenic genetic variants were associated with specific cutaneous manifestations. The p.Met41Leu variant was most frequently associated with neutrophilic dermal infiltrates (14 of 17 patients [82%]), often resembling histiocytoid Sweet syndrome. In contrast, the p.Met41Val variant was associated with vasculitic lesions (11 of 20 patients [55%]) with a mixed leukocytic infiltrate (17 of 20 patients [85%]). Oral prednisone improved skin manifestations in 67 of 73 patients (92%). Patients with VEXAS treated with anakinra frequently developed severe injection-site reactions (12 of 16 [75%]), including ulceration (2 of 12 [17%]) and abscess formation (1 of 12 [8%]). Results of this cohort study show that skin manifestations are a common and early manifestation of VEXAS syndrome. Genetic evaluation for VEXAS should be considered in older male patients with cutaneous vasculitis, neutrophilic dermatoses, or chondritis. Awareness of VEXAS among dermatologists is critical to facilitate early diagnosis.32:Tbbc,ImportanceVEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome is a newly defined genetic disease with an estimated prevalence of 1 in 4269 men older than 50 years and is marked by systemic inflammation, progressive bone marrow failure, and inflammatory cutaneous manifestations.ObjectiveTo define the spectrum of cutaneous manifestations in VEXAS syndrome and the association of these findings with clinical, genetic, and histological features.Design, Setting, and ParticipantsThis observational cohort study included data from 112 patients who were diagnosed with VEXAS-defining genetic variants in UBA1 between 2019 and 2023. Data were collected from medical record review or from patients with VEXAS directly evaluated at the National Institutes of Health in Bethesda, Maryland.Main Outcomes and MeasuresTo define the spectrum of cutaneous manifestations in VEXAS in association with genetic, histological, and other clinical findings. A secondary outcome was cutaneous response to treatment in VEXAS.ResultsAmong the 112 patients (median [range] age, 69 [39-79] years; 111 [99%] male), skin involvement was common (93 [83%]), and the most frequent presenting feature of disease (68 [61%]). Of 64 histopathologic reports available from 60 patients, predominant skin histopathologic findings were leukocytoclastic vasculitis (23 [36%]), neutrophilic dermatosis (22 [34%]), and perivascular dermatitis (19 [30%]). Distinct pathogenic genetic variants were associated with specific cutaneous manifestations. The p.Met41Leu variant was most frequently associated with neutrophilic dermal infiltrates (14 of 17 patients [82%]), often resembling histiocytoid Sweet syndrome. In contrast, the p.Met41Val variant was associated with vasculitic lesions (11 of 20 patients [55%]) with a mixed leukocytic infiltrate (17 of 20 patients [85%]). Oral prednisone improved skin manifestations in 67 of 73 patients (92%). Patients with VEXAS treated with anakinra frequently developed severe injection-site reactions (12 of 16 [75%]), including ulceration (2 of 12 [17%]) and abscess formation (1 of 12 [8%]).Conclusions and RelevanceResults of this cohort study show that skin manifestations are a common and early manifestation of VEXAS syndrome. Genetic evaluation for VEXAS should be considered in older male patients with cutaneous vasculitis, neutrophilic dermatoses, or chondritis. Awareness of VEXAS among dermatologists is critical to facilitate early diagnosis.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"prednisone: generic Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on prednisone (generic). Clinician-written summaries and actionable practice insights. Updated daily.\",\"url\":\"https://www.reachrx.ai/hub/tag/generic/prednisone\",\"breadcrumb\":{\"@type\":\"BreadcrumbList\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https://www.reachrx.ai\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Research Hub\",\"item\":\"https://www.reachrx.ai/hub\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Generics\",\"item\":\"https://www.reachrx.ai/hub/tag/generic\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"prednisone\",\"item\":\"https://www.reachrx.ai/hub/tag/generic/prednisone\"}]}}"}}]],["$","$L2f",null,{"title":"prednisone: Research & Clinical Takeaways","description":"Explore research on prednisone (generic) — efficacy, safety, and comparative data.","papers":[{"doi":"10.1016/j.jhepr.2026.102025","pmid":"42697485","title":"Autoimmune hepatitis: special groups and treatment gaps","journal_title":"JHEP Reports","journal_issn":"2589-5559","published_at":"2026-09-04T00:00:00.000Z","url":"https://doi.org/10.1016/j.jhepr.2026.102025","source_score":15,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-07T06:30:45.261Z","updated_at":"2026-09-07T06:30:45.261Z","tags":[{"paper_doi":"10.1016/j.jhepr.2026.102025","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.jhepr.2026.102025","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1016/j.jhepr.2026.102025","tag_type":"condition","value":"Autoimmune Hepatitis","value_numeric":null},{"paper_doi":"10.1016/j.jhepr.2026.102025","tag_type":"generic","value":"azathioprine","value_numeric":null},{"paper_doi":"10.1016/j.jhepr.2026.102025","tag_type":"generic","value":"mycophenolate mofetil","value_numeric":null},{"paper_doi":"10.1016/j.jhepr.2026.102025","tag_type":"generic","value":"prednisolone","value_numeric":null},{"paper_doi":"10.1016/j.jhepr.2026.102025","tag_type":"generic","value":"prednisone","value_numeric":null},{"paper_doi":"10.1016/j.jhepr.2026.102025","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1016/j.jhepr.2026.102025","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1016/j.jhepr.2026.102025","tag_type":"modality","value":"Corticosteroid","value_numeric":null},{"paper_doi":"10.1016/j.jhepr.2026.102025","tag_type":"modality","value":"Immunosuppressant","value_numeric":null},{"paper_doi":"10.1016/j.jhepr.2026.102025","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.jhepr.2026.102025","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1016/j.jhepr.2026.102025","tag_type":"warning","value":"No sample size applies — this is a review article with no original patient cohort. The sample_size tag was omitted accordingly.","value_numeric":null},{"paper_doi":"10.1016/j.jhepr.2026.102025","tag_type":"warning","value":"Study design classified as 'Narrative Review' based on abstract language; the authors do not explicitly state a systematic methodology, so formal systematic review criteria were not assumed.","value_numeric":null},{"paper_doi":"10.1016/j.jhepr.2026.102025","tag_type":"warning","value":"The paper is dated September 4, 2026 (future relative to most training data); content reflects emerging/pipeline agents that may not yet be widely available.","value_numeric":null}],"summaries":{"what_studied":"This review appraises current gaps in autoimmune hepatitis (AIH) management, with focus on special populations (e.g., elderly, pediatric, pregnant), treatment limitations of first- and second-line agents, emerging therapies, and patient-reported outcomes including fatigue, depression, and cognitive dysfunction.","key_result":"Fewer than 70% of patients achieve complete biochemical response (normal aminotransferases and IgG) by 6 months on standard therapy; more than 20% discontinue due to side effects. Evidence for second- and third-line agents comes largely from uncontrolled real-world studies. No validated AIH-specific symptom questionnaires or regulatory-accepted trial endpoints currently exist.","limitations":"- This is a narrative review without systematic search or meta-analysis, limiting the strength of conclusions.\n- Evidence base for advanced therapies relies heavily on uncontrolled, real-world data with no comparator groups.\n- Special AIH populations (e.g., pediatric, elderly, pregnant) are understudied, reducing generalizability.","practice_takeaway":"Standard AIH therapy leaves a substantial proportion of patients without full response or with intolerable side effects — clinicians should proactively monitor for fatigue, mood, and cognitive symptoms alongside liver enzymes. Emerging targeted agents may offer better tolerability, but robust trial data are still lacking."}},{"doi":"10.1007/s00467-026-07531-z","pmid":"42680935","title":"Corticosteroids in childhood IgA vasculitis: can early therapy mask kidney involvement?","journal_title":"Pediatric Nephrology","journal_issn":"0931-041X","published_at":"2026-09-02T00:00:00.000Z","url":"https://doi.org/10.1007/s00467-026-07531-z","source_score":3,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-05T06:20:03.364Z","updated_at":"2026-09-05T06:20:03.364Z","tags":[{"paper_doi":"10.1007/s00467-026-07531-z","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07531-z","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07531-z","tag_type":"condition","value":"IgA Vasculitis","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07531-z","tag_type":"condition","value":"IgA Vasculitis Nephritis","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07531-z","tag_type":"generic","value":"prednisone","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07531-z","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07531-z","tag_type":"level_of_evidence","value":"6","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07531-z","tag_type":"modality","value":"Corticosteroid","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07531-z","tag_type":"sample_size","value":"n=211","value_numeric":211},{"paper_doi":"10.1007/s00467-026-07531-z","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07531-z","tag_type":"study_design","value":"Editorial Commentary","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07531-z","tag_type":"warning","value":"Confounding by indication is explicitly acknowledged as the principal limitation — the numerically higher nephritis rate in steroid-exposed children should not be interpreted causally.","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07531-z","tag_type":"warning","value":"The appraised cohort had only 34 kidney events and 2.4-month median follow-up, making all effect estimates very imprecise.","value_numeric":null},{"paper_doi":"10.1007/s00467-026-07531-z","tag_type":"warning","value":"This is an editorial commentary, not an original study; quantitative findings are drawn from the appraised study (Kim et al., 2026) and should be interpreted in that context.","value_numeric":null}],"summaries":{"what_studied":"This editorial commentary critically appraises a retrospective single-center cohort study (Kim et al., 2026; n=211 children) asking whether early corticosteroid use for extrarenal IgA vasculitis (IgAV) symptoms alters the incidence, timing, or urinary phenotype of subsequent kidney involvement.","key_result":"Kidney involvement occurred in 21.7% (20/92) of corticosteroid-treated children vs. 11.8% (14/119) of untreated children — a difference that did not reach statistical significance (p=0.054; OR 2.083, 95% CI 0.988–4.392). Time to kidney involvement was also not significantly different (1.03 vs. 0.72 months). The commentary concludes there is no evidence that symptom-driven corticosteroid exposure prevents or delays IgAV nephritis (IgAVN), and warns that the numerically higher event rate in treated children reflects confounding by indication (greater disease severity), not causation.","limitations":"- Only 34 kidney events and a short median follow-up of 2.4 months (surveillance recommended ≥6 months) limit the study's ability to detect late-onset nephritis.\n- Confounding by indication is the principal flaw: corticosteroid-treated children had more GI involvement, arthralgia, and higher inflammatory markers.\n- Kidney biopsies were performed in only 3 children, so histologic activity cannot be related to corticosteroid exposure or urinary phenotype.","practice_takeaway":"Prior corticosteroid use should never reduce vigilance for kidney disease: continue structured urinalysis and blood-pressure monitoring on the same schedule in all children, regardless of steroid exposure, for at least 6 months after each IgAV episode. When biopsy criteria are met (UPCR >2 mg/mg, eGFR <90, or persistent moderate/mild proteinuria), do not delay biopsy because proteinuria has improved — proceed with biopsy and supportive therapy in parallel."}},{"doi":"10.1016/s2352-3026(26)00191-2","pmid":"42660130","title":"Venetoclax added to dose-adjusted EPOCH-R for newly diagnosed double-hit lymphomas: phase 2 results from ALLIANCE A051701, an open-label, randomised, controlled, phase 2–3 trial","journal_title":"The Lancet Haematology","journal_issn":"2352-3026","published_at":"2026-08-28T00:00:00.000Z","url":"https://doi.org/10.1016/s2352-3026(26)00191-2","source_score":15,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-02T06:22:24.128Z","updated_at":"2026-09-02T06:22:24.128Z","tags":[{"paper_doi":"10.1016/s2352-3026(26)00191-2","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00191-2","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00191-2","tag_type":"brand","value":"Venclexta","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00191-2","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00191-2","tag_type":"condition","value":"Double-Hit Lymphoma","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00191-2","tag_type":"condition","value":"High-Grade B-Cell Lymphoma","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00191-2","tag_type":"generic","value":"cyclophosphamide","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00191-2","tag_type":"generic","value":"doxorubicin","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00191-2","tag_type":"generic","value":"etoposide","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00191-2","tag_type":"generic","value":"prednisone","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00191-2","tag_type":"generic","value":"rituximab","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00191-2","tag_type":"generic","value":"venetoclax","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00191-2","tag_type":"generic","value":"vincristine","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00191-2","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00191-2","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00191-2","tag_type":"modality","value":"BCL2 Inhibitor","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00191-2","tag_type":"modality","value":"Chemoimmunotherapy","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00191-2","tag_type":"sample_size","value":"n=66","value_numeric":66},{"paper_doi":"10.1016/s2352-3026(26)00191-2","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00191-2","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00191-2","tag_type":"warning","value":"89% of participants were white, limiting generalizability to more diverse populations.","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00191-2","tag_type":"warning","value":"The age range (18–80) spans both adult and older_adult groups; median age was 65, suggesting a predominantly older adult population.","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00191-2","tag_type":"warning","value":"The trial was closed early due to excess mortality in the venetoclax arm; results are from an underpowered phase 2 cohort and should not be interpreted as definitive efficacy data.","value_numeric":null}],"summaries":{"what_studied":"Phase 2 RCT (ALLIANCE A051701) comparing DA-EPOCH-R alone vs. DA-EPOCH-R plus venetoclax (600 mg oral, days 1–5 per cycle) in 66 newly diagnosed double-hit lymphoma patients aged 18–80, with median follow-up of 34.7 months.","key_result":"Adding venetoclax did not improve progression-free survival (median 7.7 vs. 28.4 months; HR 1.13, 95% CI 0.53–2.37; p=0.75) and was associated with significantly worse 24-month overall survival (52% vs. 72%; HR 2.49, 95% CI 1.03–6.04; p=0.038), including 6 on-treatment deaths (17%) in the venetoclax arm vs. 1 (3%) in the control arm, prompting early trial closure.","limitations":"- Small phase 2 sample (n=66), limiting statistical power.\n- Open-label design introduces potential performance bias.\n- Predominantly white patient population (89%) limits generalizability.","practice_takeaway":"Do not add venetoclax to DA-EPOCH-R for newly diagnosed double-hit lymphoma — it increases mortality without improving disease control. DA-EPOCH-R alone provides a useful efficacy benchmark (28.4-month median PFS) for designing future trials."}},{"doi":"10.1136/jnnp-2026-339071","pmid":"42637535","title":"Balancing Benefits and Risks: Long-term Use of Daily versus Intermittent Corticosteroids in Duchenne Muscular Dystrophy","journal_title":"Journal of Neurology, Neurosurgery & Psychiatry","journal_issn":"0022-3050","published_at":"2026-08-24T00:00:00.000Z","url":"https://doi.org/10.1136/jnnp-2026-339071","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-28T06:25:29.124Z","updated_at":"2026-08-28T06:25:29.124Z","tags":[{"paper_doi":"10.1136/jnnp-2026-339071","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1136/jnnp-2026-339071","tag_type":"category","value":"Psychiatry","value_numeric":null},{"paper_doi":"10.1136/jnnp-2026-339071","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1136/jnnp-2026-339071","tag_type":"condition","value":"Duchenne Muscular Dystrophy","value_numeric":null},{"paper_doi":"10.1136/jnnp-2026-339071","tag_type":"generic","value":"deflazacort","value_numeric":null},{"paper_doi":"10.1136/jnnp-2026-339071","tag_type":"generic","value":"prednisone","value_numeric":null},{"paper_doi":"10.1136/jnnp-2026-339071","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1136/jnnp-2026-339071","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1136/jnnp-2026-339071","tag_type":"modality","value":"Corticosteroid","value_numeric":null},{"paper_doi":"10.1136/jnnp-2026-339071","tag_type":"sample_size","value":"n=219","value_numeric":219},{"paper_doi":"10.1136/jnnp-2026-339071","tag_type":"sex","value":"male","value_numeric":null},{"paper_doi":"10.1136/jnnp-2026-339071","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1136/jnnp-2026-339071","tag_type":"warning","value":"The daily regimen arm used deflazacort exclusively, while the intermittent arm included both prednisone and deflazacort — drug-specific effects cannot be fully separated from dosing schedule effects.","value_numeric":null},{"paper_doi":"10.1136/jnnp-2026-339071","tag_type":"warning","value":"The impact_flag 'practice_changing' is applied cautiously: while findings are clinically significant, the retrospective design limits causal inference.","value_numeric":null},{"paper_doi":"10.1136/jnnp-2026-339071","tag_type":"warning","value":"The study population appears to be male-only (consistent with DMD), but sex is not explicitly stated in the abstract — inferred from disease context.","value_numeric":null},{"paper_doi":"10.1136/jnnp-2026-339071","tag_type":"warning","value":"This is a retrospective, non-randomized study; treatment assignment was not controlled, so unmeasured confounding may influence the observed differences.","value_numeric":null}],"summaries":{"what_studied":"This retrospective, real-world study compared daily deflazacort vs. intermittent (10 days on/off) prednisone or deflazacort in 219 boys with DMD across three Belgian and Dutch neuromuscular centres (1995–2022), with a mean follow-up of ~10 years.","key_result":"Daily CS delayed loss of ambulation by 4 years (15.0 vs. 11.0 years, p<0.001), slowed upper and lower limb motor decline, and reduced scoliosis surgery rates (16.0% vs. 27.1%, p<0.05). However, intermittent treatment preserved height (170.2 cm vs. 140.8 cm at age 18, p<0.001), bone mineral density Z-scores (p<0.001), and was linked to fewer vertebral fractures (p<0.001). BMI, pulmonary decline, and cardiac function trajectories were similar between regimens.","limitations":"Retrospective design introduces selection bias in regimen assignment; patients were not randomized, so confounding by indication is possible. The study draws from only three centres in Belgium and the Netherlands, which may limit generalizability. Daily regimen used deflazacort exclusively, while intermittent used either prednisone or deflazacort, making direct drug comparisons difficult.","practice_takeaway":"Daily CS offers meaningful motor and spine benefits in DMD but carries significant long-term costs to growth and bone health — a trade-off that should be discussed openly with patients and families. Shared decision-making, informed by these real-world long-term data, should guide individualised regimen choice."}},{"doi":"10.1182/blood.2026033839","pmid":"42622258","title":"Fixed-duration epcoritamab plus R-CHOP in newly diagnosed LBCL with IPI score 3-5: results from the EPCORE NHL-2 trial","journal_title":"Blood Journal","journal_issn":"0006-4971","published_at":"2026-08-11T00:00:00.000Z","url":"https://doi.org/10.1182/blood.2026033839","source_score":19,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-26T06:20:06.379Z","updated_at":"2026-08-26T06:20:06.379Z","tags":[{"paper_doi":"10.1182/blood.2026033839","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1182/blood.2026033839","tag_type":"brand","value":"Epkinly","value_numeric":null},{"paper_doi":"10.1182/blood.2026033839","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1182/blood.2026033839","tag_type":"condition","value":"Large B-Cell Lymphoma","value_numeric":null},{"paper_doi":"10.1182/blood.2026033839","tag_type":"generic","value":"cyclophosphamide","value_numeric":null},{"paper_doi":"10.1182/blood.2026033839","tag_type":"generic","value":"doxorubicin","value_numeric":null},{"paper_doi":"10.1182/blood.2026033839","tag_type":"generic","value":"epcoritamab","value_numeric":null},{"paper_doi":"10.1182/blood.2026033839","tag_type":"generic","value":"prednisone","value_numeric":null},{"paper_doi":"10.1182/blood.2026033839","tag_type":"generic","value":"rituximab","value_numeric":null},{"paper_doi":"10.1182/blood.2026033839","tag_type":"generic","value":"vincristine","value_numeric":null},{"paper_doi":"10.1182/blood.2026033839","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1182/blood.2026033839","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1182/blood.2026033839","tag_type":"modality","value":"Bispecific Antibody","value_numeric":null},{"paper_doi":"10.1182/blood.2026033839","tag_type":"modality","value":"Chemoimmunotherapy","value_numeric":null},{"paper_doi":"10.1182/blood.2026033839","tag_type":"sample_size","value":"n=47","value_numeric":47},{"paper_doi":"10.1182/blood.2026033839","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1182/blood.2026033839","tag_type":"study_design","value":"Phase 1b/2 Single-Arm Trial","value_numeric":null},{"paper_doi":"10.1182/blood.2026033839","tag_type":"warning","value":"No direct comparator arm was included; the 2-year PFS/OS figures cannot be formally compared to historical R-CHOP data without adjustment for patient selection.","value_numeric":null},{"paper_doi":"10.1182/blood.2026033839","tag_type":"warning","value":"The brand name 'Epkinly' is used for epcoritamab; confirm regulatory approval status in your region for the frontline LBCL indication, as this trial is investigational.","value_numeric":null},{"paper_doi":"10.1182/blood.2026033839","tag_type":"warning","value":"The phase 3 confirmatory trial (NCT04663347 or successor) is described as 'ongoing' — clinicians should check for updated results before adopting this regimen.","value_numeric":null}],"summaries":{"what_studied":"Phase 1b/2 single-arm study (EPCORE NHL-2, Arm 1) evaluating epcoritamab added to R-CHOP (6 cycles) for 1 year total in 47 adults with newly diagnosed CD20+ LBCL and high-risk IPI scores of 3–5.","key_result":"ORR was 98% and CR rate was 85%; at median follow-up of 44.2 months, median DOCR, PFS, and OS were not reached; estimated 2-year PFS was 80% and 2-year OS was 87%. MRD negativity was achieved in 100% of evaluable patients. CRS occurred in 60% of patients but was predominantly grade 1–2 and all events resolved.","limitations":"Single-arm design with no comparator limits conclusions about benefit over R-CHOP alone; small sample size (n=47) reduces precision; investigator-assessed endpoints introduce potential bias.","practice_takeaway":"For high-risk newly diagnosed LBCL (IPI 3–5), epcoritamab plus R-CHOP showed durable responses in this early-phase study — but wait for the ongoing phase 3 trial before changing frontline practice. CRS was common yet manageable, so step-up dosing protocols and monitoring should be in place."}},{"doi":"10.1136/lupus-2026-002188","pmid":"42508962","title":"Risk of falls, recurrent falls and osteoporotic fractures in SLE patients with comorbid fibromyalgia: a propensity score-matched cohort study using the TriNetX Network","journal_title":"Lupus Science & Medicine","journal_issn":"2053-8790","published_at":"2026-07-27T00:00:00.000Z","url":"https://doi.org/10.1136/lupus-2026-002188","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-04T18:18:05.264Z","updated_at":"2026-08-04T18:18:05.264Z","tags":[{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"condition","value":"Falls","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"condition","value":"Fibromyalgia","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"condition","value":"Osteoporotic Fractures","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"condition","value":"Systemic Lupus Erythematosus","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"generic","value":"amitriptyline","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"generic","value":"duloxetine","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"generic","value":"gabapentin","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"generic","value":"hydroxychloroquine","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"generic","value":"milnacipran","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"generic","value":"prednisone","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"generic","value":"pregabalin","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"modality","value":"Antimalarial","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"modality","value":"Gabapentinoid","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"modality","value":"Glucocorticoid","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"modality","value":"Serotonin-Norepinephrine Reuptake Inhibitor","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"modality","value":"Tricyclic Antidepressant","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"sample_size","value":"n=47550","value_numeric":47550},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"study_design","value":"Propensity Score-Matched Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"warning","value":"Outcomes 3 (thoracolumbar vertebral fractures) and 4 (osteoporotic fractures) partially overlap at the vertebral level and are not statistically independent; they are reported separately by design.","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"warning","value":"The cohort was ~96% female, reflecting SLE demographics; findings may have limited generalizability to male SLE patients.","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"warning","value":"The 'impact_flag' of practice_changing is applied cautiously — findings are observational and the authors explicitly call for prospective confirmation before clinical guideline changes.","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"warning","value":"The landmark sensitivity analysis (8,458 matched pairs) showed modestly stronger associations (falls HR 1.68 vs 1.37), suggesting the primary design may slightly underestimate true risk due to survivorship of the exposed cohort until FM diagnosis.","value_numeric":null}],"summaries":{"what_studied":"This propensity score-matched (PSM) retrospective cohort study used the TriNetX US Collaborative Network to assess whether comorbid fibromyalgia (FM) independently increases the risk of falls, recurrent falls, thoracolumbar vertebral fractures, and osteoporotic fractures in adult SLE patients over a 5-year follow-up period (6-month washout; 2013–2024).","key_result":"After 1:1 PSM (23,775 matched pairs), SLE+FM patients had significantly higher 5-year risks vs. SLE-only: incident falls (aHR 1.38, 95% CI 1.29–1.48), recurrent falls (aHR 1.53, 95% CI 1.32–1.76), thoracolumbar vertebral fractures (aHR 1.18, 95% CI 1.01–1.37), and osteoporotic fractures (aHR 1.14, 95% CI 1.02–1.27); Kaplan-Meier curves diverged early and progressively.","limitations":"- Bone mineral density (DXA T-scores) was unavailable in TriNetX and could not be adjusted for, leaving residual confounding for fracture outcomes.\n- Cumulative glucocorticoid dose/duration, menopausal status, physical activity, disease activity, frailty, and opioid/benzodiazepine use were unmeasured or only coarsely captured.\n- All outcomes were ICD-10-CM code–based (not clinically adjudicated), so low-trauma fractures cannot be distinguished from high-energy events, and asymptomatic morphometric vertebral fractures were likely undercaptured.","practice_takeaway":"Screen SLE patients routinely for comorbid FM, as it independently raises fall risk by 38% and recurrent fall risk by 53% — risks that are additive to SLE's baseline skeletal fragility. For SLE patients with FM, integrate multidisciplinary fall-prevention strategies (balance/strength assessment, review of gabapentinoids, TCAs, and SNRIs) alongside bone-protective therapy."}},{"doi":"10.1016/j.ard.2026.06.009","pmid":"42481270","title":"2025 EULAR recommendations for the management of polymyalgia rheumatica and primary large vessel vasculitis","journal_title":"Annals of the Rheumatic Diseases","journal_issn":"0003-4967","published_at":"2026-07-21T00:00:00.000Z","url":"https://doi.org/10.1016/j.ard.2026.06.009","source_score":14,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-25T13:57:47.110Z","updated_at":"2026-07-25T13:57:47.110Z","tags":[{"paper_doi":"10.1016/j.ard.2026.06.009","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.009","tag_type":"brand","value":"Rinvoq","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.009","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.009","tag_type":"condition","value":"Giant Cell Arteritis","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.009","tag_type":"condition","value":"Large Vessel Vasculitis","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.009","tag_type":"condition","value":"Polymyalgia Rheumatica","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.009","tag_type":"condition","value":"Takayasu Arteritis","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.009","tag_type":"generic","value":"methotrexate","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.009","tag_type":"generic","value":"prednisone","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.009","tag_type":"generic","value":"upadacitinib","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.009","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.009","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.009","tag_type":"modality","value":"Glucocorticoid","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.009","tag_type":"modality","value":"IL-6 Receptor Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.009","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.009","tag_type":"study_design","value":"Clinical Practice Guideline","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.009","tag_type":"warning","value":"Brand tag 'Rinvoq' added for upadacitinib; confirm formulary availability and licensed indications for GCA in the relevant jurisdiction, as this may be a newer indication.","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.009","tag_type":"warning","value":"Level of evidence assigned as '4' (expert consensus/guideline) since this is a recommendations paper, not a primary clinical trial; individual underlying recommendations may carry different evidence grades not specified in the abstract.","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.009","tag_type":"warning","value":"No sample size is applicable — this is a task force consensus document, not a patient-level study.","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.06.009","tag_type":"warning","value":"The DOI and publication date (2026-07-21) are in the future relative to typical indexing cycles — verify final publication status before citing in clinical use.","value_numeric":null}],"summaries":{"what_studied":"Updated EULAR recommendations for managing polymyalgia rheumatica (PMR), giant cell arteritis (GCA), and Takayasu arteritis (TAK), developed by an international task force using systematic literature reviews of evidence published since the 2015 PMR and 2018 GCA/TAK guidelines.","key_result":"The task force produced 4 overarching principles, 12 recommendations, and 2 quality indicators with high levels of agreement. Key updates include: immediate GC start for suspected GCA (without waiting for confirmatory tests); GC initiation at 15–25 mg/day for PMR and 40–60 mg/day for GCA/TAK; IL-6 receptor inhibitors as adjunctive therapy for PMR and GCA; upadacitinib as an option for GCA; and mandatory GC-sparing agents for all TAK patients.","limitations":"As a consensus recommendations paper, the strength of individual recommendations depends on underlying trial evidence, which may be limited for some conditions (especially TAK). The systematic reviews cover only data published after prior guideline versions, so older evidence is inherited rather than re-evaluated.","practice_takeaway":"Refer all suspected GCA patients to a specialist within 24 hours and start glucocorticoids immediately — do not wait for biopsy or imaging results. For GCA or TAK, combine GC with a GC-sparing agent (IL-6 receptor inhibitor, upadacitinib, or methotrexate) in selected patients; all TAK patients should receive combination therapy."}},{"doi":"10.1002/acr.80119","pmid":"42482401","title":"Clinician and patient factors associated with long‐term glucocorticoid use in people with rheumatoid arthritis on advanced therapies","journal_title":"Arthritis Care & Research","journal_issn":"2151-464X","published_at":"2026-07-21T00:00:00.000Z","url":"https://doi.org/10.1002/acr.80119","source_score":3,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-27T14:09:13.770Z","updated_at":"2026-07-27T14:09:13.770Z","tags":[{"paper_doi":"10.1002/acr.80119","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/acr.80119","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1002/acr.80119","tag_type":"condition","value":"Rheumatoid Arthritis","value_numeric":null},{"paper_doi":"10.1002/acr.80119","tag_type":"generic","value":"prednisone","value_numeric":null},{"paper_doi":"10.1002/acr.80119","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1002/acr.80119","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/acr.80119","tag_type":"modality","value":"Biologic","value_numeric":null},{"paper_doi":"10.1002/acr.80119","tag_type":"modality","value":"Glucocorticoid","value_numeric":null},{"paper_doi":"10.1002/acr.80119","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1002/acr.80119","tag_type":"sample_size","value":"n=7162","value_numeric":7162},{"paper_doi":"10.1002/acr.80119","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/acr.80119","tag_type":"study_design","value":"Registry-Based Cohort Study with Nested Clinician Survey","value_numeric":null},{"paper_doi":"10.1002/acr.80119","tag_type":"warning","value":"Only 36% of clinicians responded to the survey; non-responders managed 3,196 patients and may differ systematically from responders, limiting generalizability of clinician-level findings.","value_numeric":null},{"paper_doi":"10.1002/acr.80119","tag_type":"warning","value":"Patient-level sample size (n=7,162) reflects both survey responders and non-responders; clinician-factor analyses used only the responder subset (n=3,966 patients from 81 clinicians).","value_numeric":null},{"paper_doi":"10.1002/acr.80119","tag_type":"warning","value":"The 'impact_flag' of practice_changing is applied cautiously—the observational design cannot establish causality between clinician attitudes and GC prescribing.","value_numeric":null}],"summaries":{"what_studied":"A clinician survey nested within the CorEvitas RA registry (2023–2024) examined patient and clinician factors associated with long-term glucocorticoid (GC) use at 6 months after initiating a new biologic or JAK inhibitor in 7,162 RA patients across 256 clinicians.","key_result":"Higher disease activity, age ≤45 or >75, longer disease duration, more prior biologics/JAKi, and lung disease were linked to greater GC use. Clinicians with less concern about low-dose prednisone (≤5 mg/day) were more likely to prescribe GCs (aOR 1.98; 95% CI 1.17–3.36), but lower concern about biologics (aOR 2.47; 1.33–4.49) or JAKi safety (aOR 2.35; 1.31–4.22) showed even stronger associations.","limitations":"Only 36% of surveyed clinicians responded (92/256), raising the risk of non-response bias. The study is observational with unmeasured confounding. Findings reflect GC use at a single 6-month timepoint, not long-term trajectories.","practice_takeaway":"Clinicians who broadly downplay medication risks—not just GC-specific concerns—are more likely to keep RA patients on long-term glucocorticoids. Education efforts should address general risk-benefit attitudes, not just steroid-specific messaging."}},{"doi":"10.1007/s10067-026-08287-5","pmid":"42420573","title":"When FDG-PET/CT reveals the tracks of fever","journal_title":"Clinical Rheumatology","journal_issn":"0770-3198","published_at":"2026-07-09T00:00:00.000Z","url":"https://doi.org/10.1007/s10067-026-08287-5","source_score":6,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-15T13:26:07.248Z","updated_at":"2026-07-15T13:26:07.248Z","tags":[{"paper_doi":"10.1007/s10067-026-08287-5","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08287-5","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08287-5","tag_type":"condition","value":"Epididymo-Orchitis","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08287-5","tag_type":"condition","value":"Polyarteritis Nodosa","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08287-5","tag_type":"generic","value":"azathioprine","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08287-5","tag_type":"generic","value":"prednisone","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08287-5","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08287-5","tag_type":"level_of_evidence","value":"6","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08287-5","tag_type":"modality","value":"Corticosteroid","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08287-5","tag_type":"modality","value":"FDG-PET/CT Imaging","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08287-5","tag_type":"modality","value":"Immunosuppressant","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08287-5","tag_type":"sample_size","value":"n=1","value_numeric":1},{"paper_doi":"10.1007/s10067-026-08287-5","tag_type":"sex","value":"male","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08287-5","tag_type":"study_design","value":"Case Report","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08287-5","tag_type":"warning","value":"Histologic confirmation of PAN was not achieved; diagnosis rests on clinical, laboratory, and imaging criteria alone.","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08287-5","tag_type":"warning","value":"The specificity of the 'ant-farm-like' PET/CT pattern for PAN versus other inflammatory conditions is not yet established.","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08287-5","tag_type":"warning","value":"This is a single case report; findings cannot be generalized to a broader population.","value_numeric":null}],"summaries":{"what_studied":"A case report of a 56-year-old man with bilateral epididymo-orchitis, high fever, and disabling lower-limb myalgia in whom whole-body ¹⁸F-FDG PET/CT was used to evaluate a suspected diagnosis of polyarteritis nodosa (PAN) after extensive negative infectious and autoimmune workup.","key_result":"FDG-PET/CT revealed a bilateral 'ant-farm-like' pattern of irregular uptake along femoral vascular trajectories and fascial planes, supporting a clinical diagnosis of non-severe, non-HBV-associated PAN (Five-Factor Score = 0); treatment with prednisone 30 mg/day plus azathioprine 50 mg twice daily achieved clinical and biochemical response within 2 weeks. Targeted quadriceps biopsy was non-diagnostic, likely due to corticosteroid initiation 12 days prior.","limitations":"- Single case report; no generalizability.\n- Biopsy was performed 12 days after corticosteroid initiation and was non-diagnostic, leaving histologic confirmation absent.\n- The specificity of the 'ant-farm-like' PET pattern for PAN remains under evaluation.","practice_takeaway":"In patients with unexplained fever, lower-limb myalgia, and epididymo-orchitis, the bilateral 'ant-farm-like' FDG-PET/CT pattern along femoral vascular and fascial planes should raise strong suspicion for PAN and can guide biopsy site selection. When biopsy is planned, it should ideally be performed before or very early after corticosteroid initiation to maximize diagnostic yield."}},{"doi":"10.1080/09273948.2026.2689365","pmid":"42417824","title":"Severe Paraneoplastic Anterior and Posterior Scleritis Associated with Myelodysplastic Syndrome","journal_title":"Ocular Immunology and Inflammation","journal_issn":"0927-3948","published_at":"2026-07-08T00:00:00.000Z","url":"https://doi.org/10.1080/09273948.2026.2689365","source_score":2,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-12T13:19:42.316Z","updated_at":"2026-07-12T13:19:42.316Z","tags":[{"paper_doi":"10.1080/09273948.2026.2689365","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2689365","tag_type":"brand","value":"Rituxan","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2689365","tag_type":"category","value":"Ophthalmology","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2689365","tag_type":"condition","value":"Myelodysplastic Syndrome","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2689365","tag_type":"condition","value":"Paraneoplastic Syndrome","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2689365","tag_type":"condition","value":"Scleritis","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2689365","tag_type":"generic","value":"prednisone","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2689365","tag_type":"generic","value":"rituximab","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2689365","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2689365","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2689365","tag_type":"modality","value":"Anti-CD20 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2689365","tag_type":"modality","value":"Corticosteroid","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2689365","tag_type":"sample_size","value":"n=1","value_numeric":1},{"paper_doi":"10.1080/09273948.2026.2689365","tag_type":"sex","value":"male","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2689365","tag_type":"study_design","value":"Case Report","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2689365","tag_type":"warning","value":"Brand name 'Rituxan' assigned for rituximab; confirm local formulary name as biosimilars may apply.","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2689365","tag_type":"warning","value":"The paraneoplastic nature of the scleritis is presumed based on temporal association with MDS — no mechanistic proof is provided.","value_numeric":null},{"paper_doi":"10.1080/09273948.2026.2689365","tag_type":"warning","value":"This is a single case report; conclusions about treatment efficacy and malignancy association are hypothesis-generating only.","value_numeric":null}],"summaries":{"what_studied":"A case report and literature review describing a 59-year-old male with severe unilateral anterior and posterior scleritis (with ciliochoroidal detachment and secondary angle closure) that led to the diagnosis of high-risk myelodysplastic syndrome (MDS), evaluating presentation, treatment response, and outcomes.","key_result":"Prednisone alone could not be tapered below 30 mg without recurrence; rituximab infusions achieved ocular symptom resolution and successful steroid taper, but the patient died while on chemotherapy before allogenic bone marrow transplantation.","limitations":"Single case report limits generalizability. No control or comparison group. Causal link between MDS and scleritis is presumed (paraneoplastic) but not mechanistically confirmed.","practice_takeaway":"Consider malignancy workup — including full blood counts and hematology referral — in patients with unexplained cytopenias, severe scleritis at presentation, or steroid-refractory scleritis. If an underlying cancer is found, definitive scleritis treatment requires treating the malignancy itself."}},{"doi":"10.1136/rmdopen-2026-006866","pmid":"42414038","title":"Glucocorticoid in giant cell arteritis: real-world treatment patterns over time and associated burden in a nationwide hospital-based study within the French health insurance database","journal_title":"RMD Open","journal_issn":"2056-5933","published_at":"2026-07-07T00:00:00.000Z","url":"https://doi.org/10.1136/rmdopen-2026-006866","source_score":10,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-14T13:24:15.561Z","updated_at":"2026-07-14T13:24:15.561Z","tags":[{"paper_doi":"10.1136/rmdopen-2026-006866","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2026-006866","tag_type":"brand","value":"Actemra","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2026-006866","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2026-006866","tag_type":"condition","value":"Giant Cell Arteritis","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2026-006866","tag_type":"generic","value":"methotrexate","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2026-006866","tag_type":"generic","value":"prednisone","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2026-006866","tag_type":"generic","value":"tocilizumab","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2026-006866","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2026-006866","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2026-006866","tag_type":"modality","value":"Disease-Modifying Antirheumatic Drug","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2026-006866","tag_type":"modality","value":"Glucocorticoid","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2026-006866","tag_type":"modality","value":"IL-6 Receptor Inhibitor","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2026-006866","tag_type":"sample_size","value":"n=18301","value_numeric":18301},{"paper_doi":"10.1136/rmdopen-2026-006866","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2026-006866","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2026-006866","tag_type":"warning","value":"GC exposure is likely underestimated because IV methylprednisolone pulses given in hospital were not captured in the claims data.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2026-006866","tag_type":"warning","value":"The association at the lowest dose category (≤5 mg/day) with MACE and infection has wide confidence intervals, suggesting limited precision at this end of the dose range.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2026-006866","tag_type":"warning","value":"The study is observational with time-varying confounding; causal inference about GC dose and adverse outcomes should be made cautiously.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2026-006866","tag_type":"warning","value":"Upadacitinib is mentioned in the discussion as a GC-sparing agent but was not part of the exposure analysis; its real-world uptake is not described in this dataset.","value_numeric":null}],"summaries":{"what_studied":"This nationwide retrospective cohort study used the French health insurance database (SNDS) to characterize oral glucocorticoid (GC) use trajectories in the 2 years following GCA diagnosis among 18,301 incident cases (2010–2022), and assessed associations between cumulative GC exposure and mortality, serious infections, MACE, and osteoporotic fractures.","key_result":"Four GC trajectories were identified; mean 2-year cumulative dose fell from 9.4 g (2010) to 7.6 g (2022) but remained high. Each additional gram of GC was linked to higher all-cause mortality (HR 1.024, 95% CI 1.021–1.027). Even the lowest dose category (≤5 mg/day) was associated with increased serious infection (HR 1.13, 95% CI 1.00–1.29) and MACE (HR 1.04, 95% CI 1.01–1.08). Tocilizumab use exceeded 25% of patients diagnosed in 2022.","limitations":"- Claims data lacked clinical/biological variables (e.g., disease activity, CRP values), so residual confounding by indication is possible.\n- In-hospital IV methylprednisolone pulses were not captured, likely underestimating true cumulative GC exposure.\n- Vertebral fractures are known to be under-reported in administrative databases, so GC-related fracture burden is probably underestimated.","practice_takeaway":"Clinicians should prioritize early GC-sparing therapy (tocilizumab or methotrexate) in all GCA patients, especially those who are older, female, hypertensive, or have kidney or neurocognitive disease—groups that taper more slowly and face the greatest toxicity risk. Even maintenance doses ≤5 mg/day carry measurable cardiovascular and infection risk, reinforcing the goal of full GC withdrawal."}},{"doi":"10.1183/16000617.0032-2026","pmid":"42386313","title":"Implementing acute exacerbations of COPD care bundles: evidence, effectiveness and future directions","journal_title":"European Respiratory Review","journal_issn":"0905-9180","published_at":"2026-07-01T00:00:00.000Z","url":"https://doi.org/10.1183/16000617.0032-2026","source_score":5,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-08T13:26:37.172Z","updated_at":"2026-07-08T13:26:37.172Z","tags":[{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"condition","value":"Acute Exacerbation of COPD","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"condition","value":"Chronic Obstructive Pulmonary Disease","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"generic","value":"prednisolone","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"generic","value":"prednisone","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"modality","value":"Antimicrobial Stewardship","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"modality","value":"Care Bundle","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"modality","value":"Digital Health Decision Support","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"modality","value":"Noninvasive Ventilation","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"modality","value":"Pulmonary Rehabilitation","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"modality","value":"Systemic Corticosteroid","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"warning","value":"Impact flag 'limited_evidence' reflects heterogeneous real-world effectiveness, not absence of plausible benefit; some controlled studies do show significant short-term readmission reductions.","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"warning","value":"Level of evidence set to 5 (narrative review/expert synthesis); individual trials cited within the review include higher-quality designs but the review itself does not perform a formal meta-analysis.","value_numeric":null},{"paper_doi":"10.1183/16000617.0032-2026","tag_type":"warning","value":"No sample size tag was applied — this is a narrative review synthesising multiple studies rather than a single study with one N; the largest cited meta-analysis included 65,945 patients.","value_numeric":null}],"summaries":{"what_studied":"This narrative review synthesised evidence (PubMed, Embase, Cochrane; 2000–2025) on the structure, implementation and clinical impact of care bundles for acute exacerbations of COPD (AECOPD), covering both the acute in-hospital phase and the discharge/transitional care period.","key_result":"Discharge-focused bundles were associated with fewer readmissions in pooled analyses (risk ratio 0.80, 95% CI 0.65–0.99), but no significant benefit for mortality or HRQoL. One transition-bundle trial reduced 7-day readmissions from 5.5% to 1.0% and 30-day from 18.2% to 15.1%, yet 90-day rates were unchanged. Large real-world multisite studies showed no reduction in 28-day (OR 1.02) or 90-day COPD readmission (OR 1.00), in-hospital mortality (OR 1.01) or 90-day mortality (OR 1.05), highlighting marked heterogeneity.","limitations":"- Narrative review design with no meta-analysis; evidence synthesis is qualitative and selective.\n- Underlying trials are heterogeneous in bundle content, fidelity reporting and outcome definitions, limiting direct comparison.\n- Real-world effectiveness is highly context-dependent (staffing, service organisation, post-discharge support), so findings may not generalise across settings.","practice_takeaway":"Implement AECOPD care bundles as structured delivery frameworks—not checklists—covering optimised pharmacotherapy, inhaler technique education, smoking cessation, pulmonary rehabilitation referral and a time-defined early follow-up (within 7–30 days, with telephone contact at 72 h for high-risk patients). Benefit depends on multidisciplinary team roles, audit-and-feedback cycles and strong post-discharge support rather than on adding more bundle components."}},{"doi":"10.2340/actadv.v106.adv-2026-0612","pmid":"42343578","title":"Recurrent Cutaneous Eosinophilic Vasculitis: A Systematic Review of Clinicopathologic Features and Treatment Outcomes","journal_title":"Acta Dermato-Venereologica","journal_issn":"1651-2057","published_at":"2026-06-24T00:00:00.000Z","url":"https://doi.org/10.2340/actadv.v106.adv-2026-0612","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-27T13:27:57.156Z","updated_at":"2026-06-27T13:27:57.156Z","tags":[{"paper_doi":"10.2340/actadv.v106.adv-2026-0612","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0612","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0612","tag_type":"condition","value":"Eosinophilic Granulomatosis With Polyangiitis","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0612","tag_type":"condition","value":"Recurrent Cutaneous Eosinophilic Vasculitis","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0612","tag_type":"generic","value":"azathioprine","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0612","tag_type":"generic","value":"cyclophosphamide","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0612","tag_type":"generic","value":"dapsone","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0612","tag_type":"generic","value":"methotrexate","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0612","tag_type":"generic","value":"prednisolone","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0612","tag_type":"generic","value":"prednisone","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0612","tag_type":"generic","value":"tacrolimus","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0612","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0612","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0612","tag_type":"modality","value":"Corticosteroid","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0612","tag_type":"sample_size","value":"n=24","value_numeric":24},{"paper_doi":"10.2340/actadv.v106.adv-2026-0612","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0612","tag_type":"study_design","value":"Systematic Review of Case Reports and Case Series","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0612","tag_type":"warning","value":"Only 24 unique cases across 20 reports; all findings are descriptive and should not be interpreted as precise prevalence estimates. Denominators vary by item due to inconsistent reporting across source publications.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0612","tag_type":"warning","value":"Some included cases may represent early-stage EGPA or hypereosinophilic syndrome given limited systemic workup and short follow-up in source reports — diagnosis of RCEV remains partly exclusionary.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0612","tag_type":"warning","value":"The provisional diagnostic framework presented in Table IV is unvalidated and intended only as a refinement hypothesis requiring prospective study.","value_numeric":null}],"summaries":{"what_studied":"Systematic review of 20 published reports (24 unique cases) of recurrent cutaneous eosinophilic vasculitis (RCEV/RCNEV) to characterize clinicopathologic features, treatments, and outcomes; literature searched through February 16, 2026.","key_result":"Most patients (70.8% female; median age 58) presented with relapsing pruritic purpura of the lower extremities. Peripheral eosinophilia was present in 88.9% of tested cases (median 1,700 cells/µL); ANCA was negative in all 22 tested cases. Systemic corticosteroids induced prompt improvement in 66.7%, but 71.4% relapsed during tapering or after withdrawal. At last follow-up (median 8 months), only 36.8% had no recurrence.","limitations":"- Evidence base is almost entirely case reports and small case series with heterogeneous reporting and frequent missing data, making descriptive synthesis unreliable for precise estimates.\n- Publication bias is likely; some cases may represent early or incompletely evaluated EGPA or hypereosinophilic syndrome.\n- Follow-up was short and inconsistent (median 8 months, range 2–276), limiting conclusions about long-term outcomes.","practice_takeaway":"Expect relapse when tapering steroids — most patients flare at low doses (median relapse threshold ~5 mg/day prednisone) — so monitor closely and consider steroid-sparing agents early in relapse-prone cases. Rule out EGPA and hypereosinophilic syndrome at baseline and reassess over time, since ANCA negativity and absence of asthma/allergic rhinitis support RCEV but do not fully exclude systemic disease."}},{"doi":"10.1182/bloodadvances.2025019323","pmid":"42085642","title":"Infections in patients receiving daratumumab for newly diagnosed multiple myeloma: a pooled analysis of MAIA and ALCYONE","journal_title":"Blood Advances","journal_issn":"2473-9529","published_at":"2026-05-05T00:00:00.000Z","url":"https://doi.org/10.1182/bloodadvances.2025019323","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-03T13:39:01.070Z","updated_at":"2026-07-03T13:39:01.070Z","tags":[{"paper_doi":"10.1182/bloodadvances.2025019323","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019323","tag_type":"brand","value":"Darzalex","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019323","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019323","tag_type":"condition","value":"Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019323","tag_type":"generic","value":"bortezomib","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019323","tag_type":"generic","value":"daratumumab","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019323","tag_type":"generic","value":"dexamethasone","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019323","tag_type":"generic","value":"lenalidomide","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019323","tag_type":"generic","value":"melphalan","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019323","tag_type":"generic","value":"prednisone","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019323","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019323","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019323","tag_type":"modality","value":"CD38 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019323","tag_type":"modality","value":"Immunomodulatory Drug","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019323","tag_type":"modality","value":"Proteasome Inhibitor","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019323","tag_type":"sample_size","value":"n=1429","value_numeric":1429},{"paper_doi":"10.1182/bloodadvances.2025019323","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019323","tag_type":"study_design","value":"Pooled Analysis of Randomized Controlled Trials","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019323","tag_type":"warning","value":"Exposure-adjusted rates account for longer treatment duration in daratumumab arms, but the method of adjustment (first-event only per patient per EAIR calculation) may underestimate cumulative infection burden in long-term survivors.","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019323","tag_type":"warning","value":"Study was industry-sponsored (Johnson & Johnson); several authors are employees or have financial ties to the sponsor.","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019323","tag_type":"warning","value":"The two pooled trials (MAIA and ALCYONE) had different backbone regimens and treatment durations, which may limit direct comparability of infection rates between studies.","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019323","tag_type":"warning","value":"This is a post hoc pooled analysis; no formal inferential statistics were performed, so comparisons between groups are descriptive only.","value_numeric":null}],"summaries":{"what_studied":"Pooled post hoc analysis of infection incidence, timing, and management in transplant-ineligible newly diagnosed multiple myeloma (NDMM) patients from the phase 3 MAIA (D-Rd vs Rd) and ALCYONE (D-VMP vs VMP) trials; pooled safety population of 1,429 patients with median age 72 years (range 40–93) and median follow-up of 64.5 months (MAIA) and 86.7 months (ALCYONE).","key_result":"Crude incidence of grade 3/4 infections was higher with daratumumab-based regimens vs controls (36.9% vs 22.4%), but exposure-adjusted incidence rates (EAIRs) were comparable (1.19 vs 1.41 per 100 patient-months). Grade 5 infection rates were low (3.0% vs 1.5%) with similar EAIRs (0.07 vs 0.08). Infections led to treatment discontinuation in ~2% of patients across all arms. The highest grade 3/4 infection risk occurred in the first 6 months of treatment in both groups.","limitations":"- Post hoc, descriptive analysis with no formal statistical comparisons.\n- Clinical trial populations may have better baseline performance status than real-world NDMM patients, potentially underestimating infection risk.\n- IMWG infection prophylaxis guidelines were published after full enrollment, so prophylaxis was not standardized per current recommendations.","practice_takeaway":"When counseling transplant-ineligible NDMM patients starting daratumumab-based therapy, emphasize that the first 6 months carry the highest infection risk and warrant close monitoring plus prophylaxis per current IMWG guidelines (levofloxacin antibacterial, acyclovir antiviral, and trimethoprim–sulfamethoxazole for high-risk patients). Exposure-adjusted infection rates are similar to non-daratumumab regimens, so the survival benefit of adding daratumumab is not offset by a meaningfully higher per-month infection burden."}},{"doi":"10.1016/s2665-9913(26)00072-x","pmid":"41936369","title":"Glucocorticoid treatment in patients with inflammatory rheumatic diseases: current practice and open questions","journal_title":"The Lancet Rheumatology","journal_issn":"2665-9913","published_at":"2026-04-03T00:00:00.000Z","url":"https://doi.org/10.1016/s2665-9913(26)00072-x","source_score":58,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-07T22:50:11.478Z","updated_at":"2026-05-07T22:50:11.478Z","tags":[{"paper_doi":"10.1016/s2665-9913(26)00072-x","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00072-x","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00072-x","tag_type":"condition","value":"Inflammatory Rheumatic Musculoskeletal Diseases","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00072-x","tag_type":"condition","value":"Polymyalgia Rheumatica","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00072-x","tag_type":"condition","value":"Rheumatoid Arthritis","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00072-x","tag_type":"condition","value":"Systemic Lupus Erythematosus","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00072-x","tag_type":"generic","value":"prednisone","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00072-x","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00072-x","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00072-x","tag_type":"modality","value":"Disease-Modifying Antirheumatic Drug","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00072-x","tag_type":"modality","value":"Glucocorticoid","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00072-x","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00072-x","tag_type":"warning","value":"Level of evidence assigned as 5 (expert review/narrative); no formal GRADE or systematic methodology is described.","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00072-x","tag_type":"warning","value":"No specific sample size is reported — this is a review article, not a primary study.","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00072-x","tag_type":"warning","value":"The paper does not specify brand or generic GC names beyond dosing thresholds; 'prednisone' is inferred as the canonical reference agent but the review may include other GC agents.","value_numeric":null}],"summaries":{"what_studied":"This review evaluates current glucocorticoid (GC) prescribing practices versus guideline recommendations in rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and polymyalgia rheumatica (PMR), examining strategies for dose reduction, discontinuation, and potential safe long-term very low-dose use.","key_result":"Despite international guidelines recommending short-term, lowest-effective-dose GC as bridging therapy, registry and cohort data show chronic GC use (>6 months) remains common; emerging evidence suggests very low doses (<5 mg/day) with careful monitoring may offer an acceptable safety profile, though cumulative risks persist.","limitations":"This is a narrative review without systematic search or meta-analysis, limiting the strength of its evidence synthesis. It focuses on only three conditions (RA, SLE, PMR), restricting generalizability. Barriers to guideline implementation are discussed qualitatively without quantified impact data.","practice_takeaway":"Aim to taper GCs to the lowest effective dose and discontinue when feasible, using DMARDs or immunomodulatory agents to enable this. When long-term GC use is unavoidable, very low doses (<5 mg/day) with structured monitoring may be a reasonable strategy, but cumulative toxicity risk must still be tracked."}},{"doi":"10.1001/jamaoncol.2026.0042","pmid":"41746629","title":"Treatment of Follicular Lymphoma With CHOP and Anti-CD20 Therapy","journal_title":"JAMA Oncology","journal_issn":"2374-2437","published_at":"2026-02-26T00:00:00.000Z","url":"https://doi.org/10.1001/jamaoncol.2026.0042","source_score":113,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-15T13:23:01.590Z","updated_at":"2026-05-15T13:23:01.590Z","tags":[{"paper_doi":"10.1001/jamaoncol.2026.0042","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0042","tag_type":"brand","value":"Rituxan","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0042","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0042","tag_type":"condition","value":"Follicular Lymphoma","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0042","tag_type":"generic","value":"cyclophosphamide","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0042","tag_type":"generic","value":"doxorubicin","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0042","tag_type":"generic","value":"prednisone","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0042","tag_type":"generic","value":"rituximab","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0042","tag_type":"generic","value":"vincristine","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0042","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0042","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0042","tag_type":"modality","value":"Chemoimmunotherapy","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0042","tag_type":"modality","value":"Radioimmunotherapy","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0042","tag_type":"sample_size","value":"n=531","value_numeric":531},{"paper_doi":"10.1001/jamaoncol.2026.0042","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0042","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0042","tag_type":"warning","value":"CHOP-RIT involves radioimmunotherapy (e.g., ibritumomab tiuxetan), which is not explicitly named in the paper — the specific radioimmunotherapy agent used in S0016 was ibritumomab tiuxetan (Zevalin), but this is not confirmed in the provided text.","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0042","tag_type":"warning","value":"Enrollment occurred from 2001–2008; treatment landscape for FL has changed substantially since then (e.g., obinutuzumab, lenalidomide combinations), which may limit generalizability of the CHOP-RIT arm findings.","value_numeric":null},{"paper_doi":"10.1001/jamaoncol.2026.0042","tag_type":"warning","value":"The level of evidence is tagged as '2' (RCT with long-term follow-up), but the cure modeling component is a secondary/exploratory analysis, which carries lower evidentiary weight than the primary trial outcomes.","value_numeric":null}],"summaries":{"what_studied":"The SWOG S0016 trial compared R-CHOP vs. CHOP followed by radioimmunotherapy (CHOP-RIT) in 531 adults with untreated advanced-stage follicular lymphoma (FL), with 15-year follow-up (median 15.5 years) and cure modeling using background mortality rates.","key_result":"15-year OS was 70% (no difference between arms); 15-year PFS was 40% overall, but CHOP-RIT was superior to R-CHOP (47% vs. 34%; P = .004). Cure modeling estimated 42% of patients were cured, with relapse rates falling from 6.8% (years 0–5) to 0.6% (years 15–20). Highest cure rates were seen in patients with low FLIPI scores and normal β2-microglobulin.","limitations":"- Secondary/exploratory analysis of a trial not originally powered for cure modeling.\n- Enrollment ended in 2008; CHOP-RIT regimen (radioimmunotherapy) is rarely used in current practice, limiting direct applicability.\n- Long follow-up introduces informative censoring and competing mortality risks.","practice_takeaway":"A meaningful subset (~42%) of advanced-stage FL patients treated with CHOP-based chemoimmunotherapy may achieve long-term cure — clinicians should incorporate this into initial patient counseling. Low FLIPI score and normal β2-microglobulin identify patients most likely to be in the cured fraction."}},{"doi":"10.1001/jamadermatol.2024.1657","pmid":"38865133","title":"Skin Manifestations of VEXAS Syndrome and Associated Genotypes","journal_title":"JAMA Dermatology","journal_issn":"2168-6068","published_at":"2024-06-12T00:00:00.000Z","url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11170453","source_score":107,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2024-08-24","doi":"10.1001/jamadermatol.2024.1657","days":"30","issn":"2168-6068","rank":"2","field":"Clinical Medicine","score":"107","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.1001/jamadermatol.2024.1657","title":"Skin Manifestations of VEXAS Syndrome and Associated Genotypes.","journal":"JAMA dermatology","methods":"","results":"$30","abstract":"$31","keywords":[],"pubmed_id":"38865133","conclusions":"","publication_date":"2024-06-12T00:00:00"},"crossref":{"DOI":"10.1001/jamadermatol.2024.1657","URL":"https://doi.org/10.1001/jamadermatol.2024.1657","ISSN":["2168-6068"],"link":[{"URL":"https://jamanetwork.com/journals/jamadermatology/articlepdf/2819457/jamadermatology_tan_2024_oi_240018_1723648283.83383.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"822","type":"journal-article","issue":"8","score":1,"title":["Skin Manifestations of VEXAS Syndrome and Associated Genotypes"],"author":[{"given":"Isabella J.","family":"Tan","sequence":"first","affiliation":[{"name":"Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey"}]},{"given":"Marcela A.","family":"Ferrada","sequence":"additional","affiliation":[{"name":"University of Maryland School of Medicine, Baltimore"}]},{"given":"Serene","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Children’s, Cleveland, Ohio"}]},{"given":"Alice","family":"Fike","sequence":"additional","affiliation":[{"name":"Vasculitis Translational Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland"}]},{"given":"Kaitlin A.","family":"Quinn","sequence":"additional","affiliation":[{"name":"Vasculitis Translational Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland"}]},{"given":"Emma M.","family":"Groarke","sequence":"additional","affiliation":[{"name":"Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland"}]},{"given":"David B.","family":"Beck","sequence":"additional","affiliation":[{"name":"Department of Medicine and Center for Human Genetics and Genomics, NYU Grossman School of Medicine, New York University, New York"}]},{"given":"Jill","family":"Allbritton","sequence":"additional","affiliation":[{"name":"The Joint Pathology Center, Silver Spring, Maryland"}]},{"given":"Leslie","family":"Castelo-Soccio","sequence":"additional","affiliation":[{"name":"Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland"}]},{"given":"Neal S.","family":"Young","sequence":"additional","affiliation":[{"name":"Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland"}]},{"given":"Bhavisha A.","family":"Patel","sequence":"additional","affiliation":[{"name":"Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland"}]},{"given":"Peter C.","family":"Grayson","sequence":"additional","affiliation":[{"name":"Vasculitis Translational Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland"}]},{"given":"Edward W.","family":"Cowen","sequence":"additional","affiliation":[{"name":"Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland"}]}],"issued":{"date-parts":[[2024,8,1]]},"member":"10","prefix":"10.1001","source":"Crossref","volume":"160","created":{"date-time":"2024-06-12T15:01:27Z","timestamp":1718204487000,"date-parts":[[2024,6,12]]},"indexed":{"date-time":"2025-09-19T08:13:59Z","timestamp":1758269639070,"date-parts":[[2025,9,19]]},"subject":[],"abstract":"$32","language":"en","relation":{},"resource":{"primary":{"URL":"https://jamanetwork.com/journals/jamadermatology/fullarticle/2819457"}},"subtitle":[],"deposited":{"date-time":"2024-08-21T22:51:31Z","timestamp":1724280691000,"date-parts":[[2024,8,21]]},"issn-type":[{"type":"print","value":"2168-6068"}],"published":{"date-parts":[[2024,8,1]]},"publisher":"American Medical Association (AMA)","reference":[{"DOI":"10.1056/NEJMoa2026834","key":"doi240018r1","year":"2020","issue":"27","author":"Beck","volume":"383","first-page":"2628","unstructured":null,"article-title":"Somatic mutations in UBA1 and severe adult-onset autoinflammatory disease.","journal-title":"N Engl J Med","doi-asserted-by":"publisher"},{"DOI":null,"key":"doi240018r2","year":"2021","issue":"26","author":"Grayson","volume":"137","first-page":"3591","unstructured":null,"article-title":"VEXAS syndrome.","journal-title":"Blood","doi-asserted-by":null},{"DOI":"10.1053/j.seminhematol.2021.10.005","key":"doi240018r3","year":"2021","issue":"4","author":"Patel","volume":"58","first-page":"201","unstructured":null,"article-title":"VEXAS syndrome: an inflammatory and hematologic disease.","journal-title":"Semin Hematol","doi-asserted-by":"publisher"},{"DOI":"10.1001/jama.2022.24836","key":"doi240018r4","year":"2023","issue":"4","author":"Beck","volume":"329","first-page":"318","unstructured":null,"article-title":"Estimated prevalence and clinical manifestations of UBA1 variants associated with VEXAS syndrome in a clinical population.","journal-title":"JAMA","doi-asserted-by":"publisher"},{"DOI":"10.1182/blood.2022016985","key":"doi240018r5","year":"2022","issue":"13","author":"Ferrada","volume":"140","first-page":"1496","unstructured":null,"article-title":"Translation of cytoplasmic UBA1 contributes to VEXAS syndrome pathogenesis.","journal-title":"Blood","doi-asserted-by":"publisher"},{"DOI":"10.1001/jamadermatol.2021.3344","key":"doi240018r6","year":"2021","issue":"11","author":"Zakine","volume":"157","first-page":"1349","unstructured":null,"article-title":"UBA1 variations in neutrophilic dermatosis skin lesions of patients with VEXAS syndrome.","journal-title":"JAMA Dermatol","doi-asserted-by":"publisher"},{"DOI":"10.1111/bjd.v186.3","key":"doi240018r7","year":"2022","issue":"3","author":"Georgin-Lavialle","volume":"186","first-page":"564","unstructured":null,"article-title":"Further characterization of clinical and laboratory features in VEXAS syndrome: large-scale analysis of a multicentre case series of 116 French patients.","journal-title":"Br J Dermatol","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.jaad.2022.01.042","key":"doi240018r8","year":"2023","issue":"6","author":"Sterling","volume":"89","first-page":"1209","unstructured":null,"article-title":"VEXAS syndrome (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) for the dermatologist.","journal-title":"J Am Acad Dermatol","doi-asserted-by":"publisher"},{"DOI":"10.1007/s00296-023-05513-0","key":"doi240018r9","year":"2023","issue":null,"author":"Kouranloo","volume":null,"first-page":null,"unstructured":null,"article-title":"Clinical characteristics, disease trajectories and management of vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) syndrome: a systematic review.","journal-title":"Rheumatol Int","doi-asserted-by":"publisher"},{"DOI":"10.1038/s41409-022-01774-8","key":"doi240018r10","year":"2022","issue":"11","author":"Gurnari","volume":"57","first-page":"1642","unstructured":null,"article-title":"Update on VEXAS and role of allogeneic bone marrow transplant: considerations on behalf of the Chronic Malignancies Working Party of the EBMT.","journal-title":"Bone Marrow Transplant","doi-asserted-by":"publisher"},{"DOI":"10.1038/s41409-021-01544-y","key":"doi240018r11","year":"2022","issue":"2","author":"Loschi","volume":"57","first-page":"315","unstructured":null,"article-title":"Allogeneic stem cell transplantation as a curative therapeutic approach for VEXAS syndrome: a case report.","journal-title":"Bone Marrow Transplant","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.jaad.2022.10.052","key":"doi240018r12","year":"2023","issue":"4","author":"Zakine","volume":"88","first-page":"917","unstructured":null,"article-title":"Clinical and pathological features of cutaneous manifestations in VEXAS syndrome: a multicenter retrospective study of 59 cases.","journal-title":"J Am Acad Dermatol","doi-asserted-by":"publisher"},{"DOI":"10.1097/MD.0000000000003033","key":"doi240018r13","year":"2016","issue":"15","author":"Ghoufi","volume":"95","first-page":null,"unstructured":null,"article-title":"Histiocytoid Sweet syndrome is more frequently associated with myelodysplastic syndromes than the classical neutrophilic variant: a comparative series of 62 patients.","journal-title":"Medicine (Baltimore)","doi-asserted-by":"publisher"},{"DOI":"10.2340/actadv.v103.18284","key":"doi240018r14","year":"2023","issue":null,"author":"Gil-Lianes","volume":"103","first-page":null,"unstructured":null,"article-title":"Sweet syndrome: clinical presentation, malignancy association, autoinflammatory disorders and treatment response in a cohort of 93 patients with long-term follow-up.","journal-title":"Acta Derm Venereol","doi-asserted-by":"publisher"},{"DOI":"10.3389/fmed.2022.983939","key":"doi240018r15","year":"2022","issue":null,"author":"Watanabe","volume":"9","first-page":null,"unstructured":null,"article-title":"Vasculitis associated with VEXAS syndrome: a literature review.","journal-title":"Front Med (Lausanne)","doi-asserted-by":"publisher"},{"DOI":"10.1002/art.v76.6","key":"doi240018r16","year":"2024","issue":null,"author":"Corty","volume":null,"first-page":null,"unstructured":null,"article-title":"VEXAS-defining UBA1 somatic variants in 245,368 diverse individuals in the NIH All Of Us cohort.","journal-title":"Arthritis Rheumatol","doi-asserted-by":"publisher"},{"DOI":"10.1111/ijd.v62.7","key":"doi240018r17","year":"2023","issue":"7","author":"Hines","volume":"62","first-page":"938","unstructured":null,"article-title":"Cutaneous involvement in VEXAS syndrome: clinical and histopathologic findings.","journal-title":"Int J Dermatol","doi-asserted-by":"publisher"},{"DOI":"10.1111/ijd.v61.3","key":"doi240018r18","year":"2022","issue":"3","author":"Ribereau-Gayon","volume":"61","first-page":"e89","unstructured":null,"article-title":"Atypical extensive lupus tumidus-like eruption as an early presentation of VEXAS syndrome.","journal-title":"Int J Dermatol","doi-asserted-by":"publisher"}],"short-title":[],"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,8,1]]}},"content-domain":{"domain":[],"crossmark-restriction":false},"original-title":[],"container-title":["JAMA Dermatology"],"published-print":{"date-parts":[[2024,8,1]]},"reference-count":18,"published-online":null,"references-count":18,"short-container-title":["JAMA Dermatol"],"is-referenced-by-count":24},"unpaywall":{"doi":"10.1001/jamadermatol.2024.1657","is_oa":true,"title":"Skin Manifestations of VEXAS Syndrome and Associated Genotypes","updated":"2025-07-30T00:59:52+00:00","published_date":"2024-06-12","best_oa_location":{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11170453","pmh_id":"oai:pubmedcentral.nih.gov:11170453","url_for_pdf":null,"url_for_landing_page":"https://www.ncbi.nlm.nih.gov/pmc/articles/11170453"}}},"created_at":"2025-09-20T06:51:53.013Z","updated_at":"2025-09-20T07:22:45.974Z","tags":[{"paper_doi":"10.1001/jamadermatol.2024.1657","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.1657","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.1657","tag_type":"condition","value":"VEXAS Syndrome","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.1657","tag_type":"generic","value":"anakinra","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.1657","tag_type":"generic","value":"prednisone","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.1657","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.1657","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.1657","tag_type":"modality","value":"IL-1 Inhibitor","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.1657","tag_type":"modality","value":"Systemic Corticosteroid","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.1657","tag_type":"sample_size","value":"n=112","value_numeric":112},{"paper_doi":"10.1001/jamadermatol.2024.1657","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.1657","tag_type":"study_design","value":"Observational Cohort Study","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.1657","tag_type":"warning","value":"Histopathology findings are based on a subset (64 reports from 60 of 112 patients).","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.1657","tag_type":"warning","value":"Observational cohort with mixed data sources (chart review vs NIH evaluations).","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.1657","tag_type":"warning","value":"Skin treatment response was assessed by physician impression, not standardized criteria.","value_numeric":null}],"summaries":{"what_studied":"An observational cohort of 112 patients with UBA1-variant–confirmed VEXAS (2019–2023) characterized the spectrum of skin findings and their associations with genotype, histology, and other clinical features; a secondary aim assessed skin response to treatments.","key_result":"Skin involvement occurred in 93/112 (83%) and was the presenting feature in 68/112 (61%); histopathology (64 reports from 60 patients) most often showed leukocytoclastic vasculitis 23/64 (36%), neutrophilic dermatosis 22/64 (34%), and perivascular dermatitis 19/64 (30%). Genotype–phenotype links included p.Met41Leu with neutrophilic infiltrates 14/17 (82%) and p.Met41Val with vasculitic lesions 11/20 (55%) and mixed leukocytic infiltrates 17/20 (85%); prednisone improved skin in 67/73 (92%), while anakinra caused severe injection-site reactions in 12/16 (75%) with ulceration 2/12 (17%) and abscess 1/12 (8%).","limitations":"Data came from mixed sources (retrospective chart review and NIH evaluations), histopathology was available for only 60/112 patients, and treatment response was based on physician impression rather than standardized measures.","practice_takeaway":"In older men with cutaneous vasculitis, neutrophilic dermatoses, or chondritis, consider testing for VEXAS (UBA1). Prednisone often improves skin disease, while anakinra may cause frequent severe injection-site reactions."}}],"initialOffset":17,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"generic","value":"prednisone"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Generics","href":"/hub/tag/generic"},{"name":"prednisone"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"generic","hub_tag_value":"prednisone"}}}]]

Papers