Friday, 20 Sep 2019

You are here

Pregnancy Outcomes Improve in Lupus

Pregnancy for patients with lupus has long been considered high risk and associated with both medical and obstetric complications, but outcomes have improved over the last 2 decades and continue to improve. The large decline in in-hospital maternal mortality was greater for lupus pregnancies than for non-lupus pregnancies. Findings from a retrospective cohort study are published in Annals of Internal Medicine.

Researchers examined the the National Inpatient Sample database of hospitalizations of adult pregnant women with and without lupus to assess nationwide trends and disparities in maternal and fetal complications among pregnant women with lupus. They compared An estimated 93 820 pregnant women with SLE and 78 045 054 without SLE were hospitalized in the United States from 1998 through 2015.

Outcomes improved during those 18 years. Regarding in-hospital maternal mortality, lupus patients had greater improvement than those without lupus, with a rate dropping from 34 times higher (442 vs 13 per 100,000) in 1998 to 2000 to less than 5 times higher (<50 vs. 10) in 2013 to 2015.

Fetal mortality rates for SLE patients also declined, but the decrease did not reach statistical significance.

Outcomes in women with lupus in all measures are improving faster with those without lupus.According to the study authors, these findings suggest that lupus pregnancy improvements are significant over the past 18 years.

In this large study examining SLE and non-SLE pregnancies over 18 years, in-hospital maternal mortality and overall outcomes improved markedly, particularly among women with SLE. However, improvement is still needed, because SLE pregnancy risks remain high.

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Sensitivity of Temporal Artery Biopsy

Metanalysis shows that temporal artery biopsy (TAB) for the diagnosis of giant cell arteritis (GCA) has a sensitivity of 77%, similar to results seen with temporal artery imaging. These data suggest clinicians may be willing to accept a GCA diagnosis without proof by TAB.

FDA Grants Breakthrough Status for Potential Lupus Nephritis Drug

Obinutuzumab (Gazyva) has been granted Breakthrough Therapy Designation (BTD) by the U.S. Food and Drug Administration (FDA) for use in adults with lupus nephritis (LN). The drug made by Genentech, is going forward based on the Phase II NOBILITY study in adult patients with proliferative lupus nephritis (LN). Currently, there are no FDA-approved medicines for lupus nephritis.

Riociguat Fails in Systemic Sclerosis-Associated Digital Ulcers

Riociguat is an oral, selective soluble guanylate cyclase stimulator that has been studied in patients with digital ulcers (DU) due to systemic sclerosis (SSc) but study results show that short term (16 weeks) riociquat therapy does not sufficiently reduce the DU burden in SSc patients.

Nintedanib FDA Approved for Scleroderma Lung Disease

Last Friday, the US Food and Drug Administration approved Ofev (nintedanib) to slow the rate of decline in pulmonary function in adults with interstitial lung disease associated with systemic sclerosis or scleroderma, called SSc-ILD. ILD as a complication of SSc may lead to progressive loss of lung function and may be associated with a significant mortality risk. Prior to the approval of Olev, there were no FDA approved drugs for SSc-ILD.

With Autoimmunity, Checkpoint Inhibitors Can Be Used

Among patients with pre-existing autoimmune diseases who developed cancer and were treated with immune checkpoint inhibitors (ICI), flares of the underlying disease and other immune-related adverse events were common, a retrospective study conducted in France showed.