How do you counsel patients with GCA on the benefits of steroids who have already experienced vision loss?
I first tell the patient they are at considerable risk for further visual loss in the same eye or the other eye over the next 1-2 weeks.
I also let them know that, even though their risk of visual loss has been reduced, their best option for preventing further visual loss is immediately starting hig...
Dr. @Dr. First Last has lucidly outlined a time-tested, effective, and clinically proven regimen for GCA that underscores the unenviable limitations of prescribing a prolonged steroid taper for elderly (ouch! my age) patients with GCA. If started after an acute steroid "cool-down," Tocilizumab/IL-6 ...
Agree wholeheartedly with Dr. @Dr. First Last's comments. I would add one thing I do to mitigate long-term corticosteroid side effects. I taper every other day, e.g., from 60 mg daily to 70-30, then 70-10, then to 60 every other day, and so on. This speeds up achieving every other day steroids, whic...
In my experience, steroid taper is often dependent on the patient's comorbidities. Those with rheumatological issues get shared with that service; those with DM get shared with their PMD. Communication with other services is key, especially when treating with tocilizumab. I manage about a third of G...