Glucocorticoids

A 2026 review of steroid-sparing therapy across the GCA–PMR spectrum: glucocorticoids still induce remission but drive substantial cumulative toxicity, so the field has pivoted to IL-6 receptor inhibition (tocilizumab in GCA, sarilumab in PMR) and JAK inhibition (upadacitinib now approved for GCA) — none of which reliably restores treatment-free remission, against a backdrop of weak monitoring tools and GCA-specific vascular-damage risk.

A propensity-score analysis of the Lupus–Cruces–Bordeaux inception cohort: early (first-year) methylprednisolone pulses were associated with a ~40% reduction in long-term irreversible damage or death in active SLE, with benefit concentrated in moderate–severe disease — likely reflecting an MP-anchored low-steroid strategy rather than the molecule alone.