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Best of 2025: Contraception in SLE
Pregnancy in SLE gets a lot of press in the rheumatology literature, and deservedly so, since pregnancy risks can be markedly increased. It was not that many years ago that women with SLE were counseled to avoid pregnancy.
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Vitamin D and Lupus Outcomes (11.21.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.
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Treating During Pregnancy (11.14.2025)
Dr. Jack Cush reviews the journal articles, news and guidelines from this past week on RheumNow.com
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QD Clinics - Mission: APP Partners in Care Week 1
QD300: Flare or Beware (featuring Lindsay Tom, PA-C and Phong Nguyen, MD) QD301: CAR-T Cell Therapy for Lupus (featuring Philip Mease, MD and Cayla Alexander, DNP) QD302: Unweanable PMR (featuring Jack Cush, MD, and Leilani Law, https://t.co/Ow2KMAzwGK
Dr. John Cush RheumNow ( View Tweet)
WHO recommendations on GLP-1 agonists: 1) conditional recommendation - GLP-1 drugs can be used for for long-term obesity treatment by adults, except pregnant women; 2) GLP-1a use should be paired with a healthy diet and physical activity. Access to these drugs is a problem. https://t.co/jMa7rbJPby
Dr. John Cush RheumNow ( View Tweet)
Japanese ANSWER cohort (3623 RA pts on bDMARDs or JAKi) included looked at T2T in 118 RA pregnancies. 93% had full-term deliveries; 85% w/ remission or LDA maintained throughout preg. 35/118 cont' bDMARDs during preg & had signif lower DAS28-CRP vs those D/C (n 24) (P = 0.007). https://t.co/uG8m7RzSiU
Dr. John Cush RheumNow ( View Tweet)
Postmenopausal women on estrogen hormone therapy (HT) had a modest incr risk (HR 1.33; 1.32-1.35; P < .001). of a new autoimmune Dz over next 5-10 yrs (vs those not on HT) TriNetX study of 889,413 HT vs 2,6 mill (not HT) - 6.7% vs 5.3% developed autoimmune dz at 5 yrs. https://t.co/fsi32XIzLe
Dr. John Cush RheumNow ( View Tweet)
+ANA's are common in pregnancy. Study of 2159 Chinese 1st trimester pregnant women found ANAs positivity in 14.7 % (1:100 most common titer; speckled most common pattern). ANA+ assoc w/ smoking, age 30-34 yrs, multiparity, thyroid Dz & hypertension https://t.co/mRQGajVe3g https://t.co/DqE1KC4Kgo
Links:
Dr. John Cush RheumNow ( View Tweet)
Swedish Birth Registry study of adverse preg outcomes (APOs) after SSc Dx [n=941] or w/in 3 yrs [39] or > 3yrs pre-Dx [839]. SSc women have incr APOs post-Dx, including preeclampsia (RR 3.8), preterm (3.3), C-section (2.5); but also incr APO risk w/in 3 yrs of Dx
Dr. John Cush RheumNow ( View Tweet)
Systematic review of 10 studies showed TNFi exposure in utero not assoc w/ incr risk of infant severe infxn (4 RCTs); same for breast milk exposure (2 RCTs).
Infant vaccination outcomes unaffected by TNFi use, but rec delaying BCG vaccination if TNFi exposed https://t.co/02Nn6TuzR3
Dr. John Cush RheumNow ( View Tweet)
Using AI and LLMs in Qualitative Data
Dr. Bella Mehta discusses abstract 0794 (Using AI to Analyze Multilingual Qualitative Data in Lupus Pregnancy Research: A Proof of Concept with Large Language Models) presented at #ACR25
https://t.co/HFBuNxdZOF https://t.co/gKAXURq8xR
Dr. John Cush RheumNow ( View Tweet)
Marketscan claims study of 62,813 IMID women w/ 70,529 pregnancies & 69,412 births, 4,485 (7.1%) were exposed to at least one TNFi during pregnancy & 3,559 postpartum. TNFi use NOT assoc w/ SIE risk during Preg (HR 1.39; 0.95-2.05) or postpartum (HR 1.22; https://t.co/NsxOLpT0ds
Dr. John Cush RheumNow ( View Tweet)
🍼 “Stop breastfeeding if on methotrexate” — that’s what we’ve always heard.
But here’s the news 👇
📊 Latest EULAR lactation: Methotrexate = LoE 4 / C
➡️ May be considered in breastfeeding if no safer alternative exists.
💡Not first-line, not forbidden — just evidence-limited. https://t.co/IJEpZYMaFV
Dr Abhilasha Manwatkar (AIIMS Nagpur) Abhilasha21822 ( View Tweet)
Really great visual summaries by Athena Chin, Sam Whittle and colleagues: Recs for the Use DMARDs in Pregnancy and Reproductive Health for Pts w Rheumatic Disease: A Scoping Review - Oct 2025 - Arthritis Care & Research #Rheumatology #MedEdu https://t.co/zRJcTESJWN 🇦🇺 https://t.co/OYZVtLEYr7
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Suleman Bhana, MD DrBhana ( View Tweet)
New Insights into Pregnancy Outcomes and Maternal-Fetal Health in Rheumatic Diseases
At #ACR25, the ACR presented new research illuminating critical challenges and advances in pregnancy outcomes for women living with rheumatic diseases, including axial spondyloarthritis, https://t.co/nJjtTMHnD3
Dr. John Cush RheumNow ( View Tweet)
Abstract 2360: Single-center lupus pregnancy cohort found that:
🔹 Absence of DORIS remission associated w/ adverse pregnancy outcomes (Pre-term, Pre-eclampsia)
🔹 This is along with known risk factors: antihypertensive use, prior nephritis, active disease
@RheumNow #ACR25 https://t.co/STg1NBeFPo
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Reaadmissions in sle pregnancies from 66k patients
Insurance and economics seem to be very important in predictions using machine learning.
Abst#2629 #ACR25 @RheumNow https://t.co/x2oo9TOxoh
Bella Mehta bella_mehta ( View Tweet)
In healthy women, preeclampsia was more common with:
- increased calprotectin
- decreased anti-CCP (very low levels)
during pregnancy
& this has good predictive capacity for future preeclampsia. Rheum pathophys can give insights into adjacent pathology
#ACR25 ABST2628 @RheumNow https://t.co/7d5YB6n6XJ
Links:
David Liew drdavidliew ( View Tweet)
Anti ccp may be protective for preeclampsia (secondary to NETs)
Abst#2628 @RheumNow #ACR25 https://t.co/n3ge0iIiB0
Links:
Bella Mehta bella_mehta ( View Tweet)
DMARD exposure overall during pregnancy is not associated with severe maternal or neonatal morbidity, in this Ontario cohort.
We’re getting better at finding a balance with DMARDs that is safe for both mother and baby. Blanket resistance is harmful
#ACR25 ABST2627 @RheumNow https://t.co/oDOpySGS3N
David Liew drdavidliew ( View Tweet)
