This study highlights the gap between clinical research and clinical practice. The harms associated with the use of even low-dose glucocorticoids have become clearer just as we have developed alternative therapies for GCA that are safe and effective. Despite these advances, many patients use advanced therapies only after failing glucocorticoid monotherapy and, instead, use low-dose glucocorticoids to maintain remission. This approach may be driven by a number of factors, including physician and patient preferences, and the EULAR guidelines, which advocate for the use of advanced therapies mainly in patients with relapsing or refractory disease.14
Philip Seo, MD, MHS, is an associate professor of medicine at Johns Hopkins University School of Medicine. He served as the third physician editor of The Rheumatologist.
References
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