The optimization of glucocorticoid therapy for long term treatment in Connective Tissue Diseases

Short description
This webinar is focused on the optimization of glucocorticoid therapy for long term treatment in Connective tissue Diseases (CTDs).
Glucocorticoids (GCs) are essential in managing life-threatening autoimmune diseases and a cornerstone in many CTDs given their swift onset of action, necessary in flares. Several studies (RCTs) and meta-analyses have demonstrated that when administered over a long period and on a low-dose basis, GCs can slow the radiographic progression and articular damage (e.g., in early rheumatoid arthritis (RA)) by at least 50%, satisfying the conventional definition of a disease-modifying anti-rheumatic drug (DMARD). GCs use should be individualized based on patient characteristics and minimized due to their potential adverse effects (Aes) and existing comorbidities. Their chronic use, especially at medium/high dosages, might cause irreversible organ damage due to the burden of metabolic systemic effects and increased risk of infections.
Many international guidelines recommend tapering/withdrawal of GCs in sustained remission. In the context of RA treatment (and other CTDs), the use of modified-release prednisone formulations at night has offered the option of respecting circadian rhythms of both inflammatory response and HPA activation, thereby enabling low-dose GC administration to mitigate nocturnal inflammation and prolonged morning fatigue and joint stiffness. Long-term Treat-to-Target (T2T) strategies are critical in setting targets for disease activity and reducing/ discontinuing GCs once control is achieved.
Therefore, a personalized GC therapy is essential for optimal long-term outcomes. In addition, it must be keep in mind that GCs for long-term (low-dose) treatment, act at genomic level, and represent a “replacement therapy” for the reduced adrenal endogenous GCs production, due to the chronic demand related to the stress of the disease.
Speaker
Prof. Maurizio Cutolo is Professor of Rheumatology and Internal Medicine at the Laboratories of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Postgraduate School of Rheumatology, University of Genoa, Italy.
Prof. Cutolo is former President of the European Alliance of Associations for Rheumatology (EULAR) (2013-2015) and the International League of Associations for Rheumatology (ILAR-2015).
In addition, Prof. Cutolo is Advisor of the EULAR Education Committee (EsOR) and Member of the Scientific Advisory Board of the Autoimmune Association (AA - USA).
He serves as Deputy Chair of the ERN ReCONNET and as co-chair of the working group on Education & Training.
Prof. Cutolo is the founder and Chairman of the EULAR SG on “Neuroimmune Endocrinology on RMDs” and co-founder of the EULAR SG on “Microcirculation in RMDs” at EULAR. Former Vice-President (2004-2007) of the Italian Society for Rheumatology (SIR). Awards & Achievements 2023 - Research.com Medicine in Italy Leader Award
He is Senior Editor of Clin Exp Rheumatol, Associate Editor of Neuroimmunomodulation and Nutrients, and editorial board member of Ann Rheum Dis, RMDopen, Clin Rheumatol and other Journals.
Prof. Cutolo and his TEAM, are involved in the following fields of research:
- systemic sclerosis, capillaroscopy and microcirculation in rheumatic diseases
- role of sex hormones in the immune response and rheumatic diseases
- the endocrine system of D vit
- the chronotherapy of rheumatoid arthritis with night glucocorticoids
- synovial macrophages as targets for biologicals in rheumatoid arthritis
- basic research on new biosimilars in rheumatic diseases.
More info about CTDs can be found here:
reconnet.ern-net.eu/disease-info/
Details about ERN ReCONNET Education & Training Working Group can be seen here:
reconnet.ern-net.eu/wg-education-and-training/
The registration to the ERN ReCONNET Newsletter can be done following this link:
reconnet.ern-net.eu/event-and-media-newsletter/