“Are the steroids to blame?”
by John GeverContributing Editor, MedPage Today December 29, 2022
A third of patients admitted with giant cell arteritis (GCA) were rehospitalized within 6 months, largely due to complications potentially related to corticosteroid therapy, researchers found in a retrospective cohort study.
Among the cohort of 1,206 patients hospitalized for GCA in the United States, readmission rates at 6 months were 34%, according to Radjiv Goulabchand, MD, of CHU Nîmes in France, and colleagues.
About a quarter of readmissions were for infections and 15% for cardiovascular disease, the group reported in Arthritis care and research. At least 85% of the cohort had received high-dose treatment (>10 mg/day) with prednisone, which is known to be associated with a markedly increased risk of infections and cardiovascular events.
Given that 40% of the patients were in their 80s or 90s and had chronic autoimmune disease, a high readmission rate could be expected, especially for cardiovascular events, the researchers suggested. But infections requiring hospitalizations would not necessarily be expected in as many patients as in this cohort were it not for the high prevalence of high-dose steroid treatment.
“Population health management strategies aimed at identifying high-need, high-cost patients with GCA and implementing multicomponent chronic care models can improve quality of care and reduce costs. care,” Goulabchand and colleagues concluded. They also suggested that steroid-sparing treatments, such as tocilizumab (Actemra) o