How do you taper corticotropin injections (Acthar) in patients with rheumatologic disease?
In what clinical scenarios, if any, do you consider using corticotropin (e.g., ACTHar gel) for the treatment of rheumatologic disease?
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All rheumatologists will at some point in their career have a patient or two or three who do not tolerate any of the usually available steroids (po prednisone, po methylprednisolone, triamcinolone IM, IM methylprednisolone/dexamethasone, IV methylprednisolone) and who have ongoing active inflammator...
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In part, it would depend on whether the patient is already on steroids. ACTHAR has 2 components to its MOA - an ACTH component and an action secondary to MSH.
Purely from a non-Endocrinologist:
When ACTHAR is used without an underlying steroid on board, the HPA Axis (adrenal gland and probably the h...
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I typically start having them reduce dose by 1/4 of their standard dose every 2 weeks and then stop.
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