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A Canadian vasculitis patient-driven survey to highlight which prednisone-related side effects matter the most
G.K. Yardimci1, C. Pagnoux2, J. Stewart3
- Vasculitis Clinic, Mount Sinai Hospital, Department of Rheumatology, University of Toronto, ON, Canada.
- Vasculitis Clinic, Mount Sinai Hospital, Department of Rheumatology, University of Toronto, ON, Canada. christian.pagnoux@sinaihealth.ca
- CanVasc and Canada Vasculitis Foundation patient representative, Canada.
CER16594
2023 Vol.41, N°4
PI 0943, PF 0947
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PMID: 36995315 [PubMed]
Received: 15/02/2023
Accepted : 14/03/2023
In Press: 27/03/2023
Published: 18/04/2023
Abstract
OBJECTIVES:
Although management of vasculitis has evolved over the last decades, glucocorticoids (GC) have remained the cornerstone of treatment. The side effects (SE) of GC are well known by the clinicians; their importance for patients with vasculitis has not been investigated as extensively as in other rheumatological conditions.
METHODS:
An online questionnaire surveyed between April 29th. to July 31st, 2022 with Vasculitis Foundation Canada about the patient experience and SE of prednisone. The survey included 5 questions about prednisone dose and duration, 21 about specific SE (with a rating of 1-10, and one question each on worst prednisone, and worst vasculitis, SE), and four other questions about knowledge and perception of possible alternatives to prednisone (namely, avacopan).
RESULTS:
A total of 97 patients (53 GPA/MPA, 44 other vasculitides) completed the survey. Their mean duration of GC use was 62.7±83.7 months, and 49.5% of patients were still on GC (daily dose, 8.4±6.2mg). All the patients reported ≥1 GC-related SE, and 67.0% reported ≥11/19 pre-specified SE of interest. Among ranked SEs, acne was the lowest score, whereas moon face/torso hump had the highest score, just above weight gain, insomnia and decreased quality of life. Around half of the GPA/MPA patients and one-third of the others had heard about avacopan, and 68% of patients (similarly in both groups) stated they would prefer being the first to take a very new medication, such as avacopan, instead of prednisone.
CONCLUSIONS:
Ranking given to some GC-related SEs may differ between patients and physicians. GC toxicity/SE indexes should reflect this difference.
