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Managing DMARDs in pregnancy. Curbside consults by Lisa Sammaritano @RheumNow #ACR24 https://t.co/FQrLNz4yCz
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
The DESIR cohort of Dr. Franc et al. showed that female pts with early axSpA had significantly lower AMH levels vs. general population reflecting low ovarian reserve & fertility.
Mechanism?
Bigger studies need to be done
@RheumNow #ACR24 abs577 https://t.co/842rX79bq6
sheila RHEUMarampa ( View Tweet)
Is Pregnancy Truly the Solution for RA?
Pregnancy is perhaps the oldest treatment in rheumatoid arthritis (RA) and has been associated with a natural improvement in disease control in 50-75% of patients. Others, however, are not as successful with unchanged disease activity or worsening of their autoimmune disease.
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Reproductive Issues in axSpA: Fertility and Pregnancy
Axial spondyloarthritis (axSpA) affects young patients with symptom onset occurring in early adulthood. Apart from pain and quality of life, reproductive issues also arise because patients who are diagnosed with the disease are also in their reproductive age. Two interesting abstracts about reproductive issues in axSpA will be presented during the poster sessions on Saturday, November 16, 2024.
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Is it pre-eclampsia or lupus nephritis flare?
Abstract 0809: The sFlt-1/PlGF ratio may help distinguish preeclampsia from lupus nephritis in pregnancy. A low ratio ruled out preeclampsia, while a high ratio ± proteinuria suggests increased risk. @RheumNow #ACR24
Akhil Sood MD AkhilSoodMD ( View Tweet)
Hamroun et al. Meta-analysis of glucocorticoids in pregnancy and breast-feeding. Increase pre-term birth with GCs, adjusted OR 2.24. Dose-dependent effect. Minimal breastmilk transfer. @RheumNow #ACR24 Abstr#0810 https://t.co/H0o9ElsHmc https://t.co/uciFP6UOhF
Richard Conway RichardPAConway ( View Tweet)
Hamroun et al. Meta-analysis of glucocorticoids in pregnancy and breast-feeding. Increase pre-term birth with GCs, adjusted OR 2.24. Dose-dependent effect. Minimal breastmilk transfer. @RheumNow #ACR24 Abstr#0810 https://t.co/H0o9ElsHmc https://t.co/uciFP6UOhF
Richard Conway RichardPAConway ( View Tweet)
Abstract #0805
Data from OTIS Registry shows Certolizumab pegol (Cimzia) exposure during pregnancy was not associated with increased risk of major birth defects, structural defects, or adverse pregnancy outcomes. #ACR24 @RheumNow
Akhil Sood MD AkhilSoodMD ( View Tweet)
Contraception counselling in #SLE post intervention
- Contraceptive counseling rates improved from 33.9% to 55.7%
- Women over 35 were 4.09 times more likely post-intervention
- Non-Hispanic Black women were less likely than Hispanic women
#ACR24 abst#0184 @RheumNow https://t.co/sOZXnAe4ov
Bella Mehta bella_mehta ( View Tweet)
High serum BAFF as a novel RF for dev't of preeclampsia in pregnant SLE pts?
This study by Dr. C Sims et al showed that SLE pregnancies w/preeclampsia had significantly higher BAFF levels during the 1st trimester, and likely w/ ⬆️dsDNA or ⬇️ complement
@RheumNow #ACR24 abs424 https://t.co/kNzyuT03r2
sheila RHEUMarampa ( View Tweet)
#ACR24 abst#0430
- Analyzed 61 SLE pregnancies
- Higher early gestational Mean Arterial Pressure before 20 Weeks linked to increased preeclampsia risk
- MAP trends at 8-10 and 17-19 weeks showed highest predictive accuracy for risk prediction
@RheumNow https://t.co/37mg0WX43v
Bella Mehta bella_mehta ( View Tweet)
FDA recently approved - fms-like tyrosine kinase 1 (s-Flt1) / placental growth factor (PlGF), for diagnosing preeclampsia.
sFlt1:PlGF≤38 rules out preeclampsia in SLE
sFlt1:PlGF>85 modestly predicts preeclampsia
Proteinuria impacts prediction accuracy #ACR24 abst#0809 @RheumNow
Bella Mehta bella_mehta ( View Tweet)
Study on pregnancy outcome disparities in SLE:
- Analyzed 685 women, 1888 pregnancies
- Pre-SLE state linked to fewer live births, higher preeclampsia risk
- Outcomes worse post-SLE diagnosis
#ACR24 abst#0440 @RheumNow https://t.co/NpEYQZ73uo
Bella Mehta bella_mehta ( View Tweet)
A systematic review highlights the impact of glucocorticoids (GC) during pregnancy and lactation. Increased risks of preterm birth were noted with GC exposure, advocating for minimized doses and pregnancy-compatible treatments. Encouragingly, low levels of GC found in breast milk… https://t.co/7CnJUBrUDQ https://t.co/ZeGHFHNT13
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
A systematic review highlights the impact of glucocorticoids (GC) during pregnancy and lactation. Increased risks of preterm birth were noted with GC exposure, advocating for minimized doses and pregnancy-compatible treatments. Encouragingly, low levels of GC found in breast milk… https://t.co/7CnJUBrUDQ https://t.co/ZeGHFHNT13
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Predictors of Adverse Pregnancy Outcomes in Lupus
A large metanalysis of systemic lupus erythematosus (SLE) patients and pregnancy outcomes suggests that adverse pregnancy outcomes are more likely in those with lupus nephritis, chronic hypertension, SLE disease activity before… https://t.co/31dqOyD3ZR https://t.co/L9LMn2CPYS
Dr. John Cush RheumNow ( View Tweet)
Predictors of Adverse Pregnancy Outcomes in Lupus
A large metanalysis of systemic lupus erythematosus (SLE) patients and pregnancy outcomes suggests that adverse pregnancy outcomes are more likely in those with lupus nephritis, chronic hypertension, SLE disease activity before and at concept
Retrospective population study of 383 #AS women who were pregnant (3.8/100,000) compared to controls. AS-Preg pts more likely to be older; White, w/ higher incomes, MORE thyroid Dz, Pregs, C-Sections, gestational DM, placenta previa, more neonatal SGA, IUFD… https://t.co/pgsmKgljwx https://t.co/IMJ8CTrqhY
Dr. John Cush RheumNow ( View Tweet)
ANA+ consult (10.18.2024)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.
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Eu Heart J - Cardiometabolic risk factors in RA Pregancy rose in last 15 yrs. RA-Preg at higher risk of preeclampsia, peripartum cardiomyopathy, arrhythmias, acute kidney injury, venous thromboembolism during hospitalizations. https://t.co/7SnjWFluCf https://t.co/H93ELPZWWz
Dr. John Cush RheumNow ( View Tweet)