In a failed sarcoidosis trial, steroid doses still fell to under 3 mg a day

The edition in brief

EFZO-FIT randomised 268 adults with pulmonary sarcoidosis needing treatment to monthly intravenous efzofitimod at two doses or placebo for 48 weeks, alongside a 12-week oral corticosteroid taper towards zero. Efzofitimod did not reduce steroid dose more than placebo (placebo-adjusted change 0.02 and −0.73 mg/day), but across the trial mean prednisone fell from 10.7 to 2.9 mg a day, leading the authors to suggest many patients can taper more aggressively. STORM-PE randomised 100 patients with intermediate-high risk pulmonary embolism to computer-assisted vacuum thrombectomy plus anticoagulation or anticoagulation alone; at 90 days, six-minute walk distance was longer (479 vs 368 m) and more patients were in NYHA class I, with no difference in mortality or recurrence, although only about two-thirds completed the walk test. A community cohort of 806 people with mild to moderate COPD found that emphysema and air trapping were linked to faster FEV1 decline and more exacerbations, while symptoms and prior exacerbations predicted exacerbations but not decline. The pearl covers a structured steroid taper in sarcoidosis.