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Internal Medicine • Rheumatology • Spondyloarthritis • Psoriatic arthritis • ACR Journal Club
How do you interpret treatment response in the DISCOVER-2 Trial when patients were allowed to remain on up to 10mg of prednisone equivalent for disease control while on guselkumab?
In clinical practice continued steroid dependence is often seen as a reason to switch therapy and providers can be especially hesitant to use systemic steroids in patients with psoriasis.
Answer from: at Community Practice
If patients were on less than or equal to prednisone 10 mg, they could continue that in the background during the trial, but note that only 20% of patients were on prednisone, a much lower figure than a typical rheumatoid arthritis trial, which is consistent with the point that rheumatologists shy a...
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Answer from: at Community Practice
The dependence on the use of systemic glucocorticoids may indeed be a good reason to change treatment. Especially in patients with psoriatic arthritis. So, if patients are unable to stop systemic glucocorticoids and there are still treatment options for the patient, this could be tried. It is diffic...
Answer from: at Academic Institution
I feel that despite allowing the patients to be treated with prednisone, the efficacy results of Guselkumab in the DISCOVER-2 trial (McInnes et al., PMID 34719872) are valid and robust due to the appropriate randomization and lack of significant confounding on the outcomes by this aspect o...