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Mediterranean Diet May Reduce Risk of RA

d Jack Cush, MD

Arthritis and Rheumatology reports that a Mediterranean diet (MD) is capable of reducing the high risk of RA among women who have smoked tobacco. The results stem from the E3N Study, a French prospective cohort study that collects dietary data on 98,995 women since 1990. An MD score was derived from standardized questionnaires.

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Updated List of Drugs Inducing Lupus

d Jack Cush, MD

Drugs inducing lupus may account for nearly 30% of all subacute cutaneous lupus erythematosus (CLE) and up to 15% of systemic lupus erythematosus (SLE) cases. Moreover there are over 100 drugs capable of inducing drug-induced lupus erythematosus.

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Comorbidities Impact Disease Activity in Spondyloarthritis

d Jack Cush, MD

An analysis of a large population-based cohort of axial spondyloarthritis (axSpA) patients shows that comorbidities are common and are associated with higher disease activity and higher levels of functional impairment.

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RheumNow Podcast - ACR Reproductive Health Slides (9-11-20)

d Jack Cush, MD

Dr. Jack Cush reviews the 2020 ACR Reproductive Health Guidelines presented all week here on RheumNow. 

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ACR 2020 Reproductive Guidelines - Lactation Guidance

d Jack Cush, MD

In this third excerpt from the ACR guidelines on managing reproductive health issues in rheumatic disease patients, we present recommendations regarding the use of glucocorticoids and guidance on lactation and medication use post-partum.

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ICYMI - The Pregnancy & Lactation Labeling Rule Explained

d Jack Cush, MD

A recent article from Healio.com reviewed the FDA’s Pregnancy and Lactation Labeling Rule (PLLR) that became effective June 30th.

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ILD studied in 679 inflammatory idiopathic myositis (IIM) pts; 508 had ILD (found in 93% amyopathic DM, 74% DM & 55% PM). Prevalence of of ILD was higher with antisynthetase Ab + and MDA-5 Ab +. Mortality higher in MDA5+ASA--IM-ILD group (33% vs 12=17%) https://t.co/ATz3wYmFuf

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post hoc analysis of Xrays in tocilizumab poly JIA pts Rx for 2 years in the TENDER and CHERISH trials, shows Tocilizumab may delay radiographic progression in children with sJIA and children with pcJIA with only 3-12% showing xray progression by 2 methods https://t.co/qwREzsaR1L

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4033 Dual-energy CT lesions from 27 pts (23 gout; 4 nonGout) shows definite MSU deposits in MTP1 & patella tendons (high density/volume, low DECT ratio) & non-gout lesions seen in larger jts (knee, midtarsal, talocrural) & tendons (Achilles, quadriceps) https://t.co/M1wK52a23C

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RheumNow Podcast - ACR Reproductive Health Slides (9-11-20) Dr Jack Cush reviews the 2020 ACR Reproductive Health Guidelines This past week we presented an overview to the new 2020 ACR ACR 2020 Reproductive Guidelines - Contraception & Counseling https://t.co/vnPh2EQZ0a https://t.co/T4y69DYIH7

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Candian study of 376 pregnancies (284 F) with #SLE and drug use: only 24.2% on antimalarials, 8.2% azathioprine, 19.7% steroids & 4.8% on NSAIDs during pregnancy. 1st trimester discontinuations seen in 16.7% of HCQ & 29.2% AZA https://t.co/a1SMwZuSlm

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Swedish registry comparison of 541 PsA 40944 non-PsA pregnancies between 1997-2014, shows PsA pregnancies had increased risks for preterm birth (adj OR 1.63) and caesarean deliveries (OR 1.47), but no increased risks for pre-eclampsia, stillbirth https://t.co/3Udpjhn1pe

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Discontinuing TNFi before wk 20 is feasible in RA and JIA pregnancy with well- controlled Dz. OTIS study of 490 women compared 25% who D/C TNFi before wk 20 vs 41% taking TNFi after wk 20. D/C TNF not assoc w/ clinical worsening in the 3rd trimester. https://t.co/DtHvQ2rbWY

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New data on tocilizumab in pregnancy, upshot is: "Tocilizumab concentrations in cord blood and infant serum were 80–90% of those in maternal serum" https://t.co/SEmyTnL7dy

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Immunomonitoring with microarrays from the SLE PROMISE pregnancy study shows that adverse outcomes (preeclampsia) can be identified by quantifying plasma cell, interferon and neutrophil RNA levels during the pregnancy https://t.co/oLOwkiGhQ2.

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117 pregnancies exposed to biologics were compared to 585 pregnancies not exposed to biologics; 6% of newborns had ≥1 congenital anomalies. No significant association between biologic exposure and congenital anomalies (HR 1.06; 95%CI 0.46-2.47) was seen. https://t.co/gsKHGiFPOS

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Systematic review of Paternal DMARD exposure prior to pregnancy shows no firm evidence of harm with TNFi, ABA, RTX, azathioprine, cyclosporine, HCQ, leflunomide, MTX or mycophenolate mofetil. Data from 84 papers, 611 male exposures, 5986 pregnancies https://t.co/VgEsrXhfdh

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The PARA study shows among 249 pregnancies (2002-08), breastfeading was less in RA - at 4-6, 12 & 26 wks postpartum 43%, 26% and 9% of the RA breastfed (vs 63%, 46% &; 41% in controls). Many patients D/C breastfeeding so they could start medication. https://t.co/2205YnoHsb https://t.co/mMyLgMNFfM

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Small study of 25 pregnancies in RA compared those who continued biologics till conception vs those who stopped before conception. Continuing biologics till conception lead to a significantly shorter time to pregnancy. https://t.co/x9EptzkvYr

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Dr Uma Mahadevan and colleagues have published guidelines for managing pregnancy in IBD patients. Rec coordinated care w/ maternal-fetal medicine subspecialist, GI doc, preconception planning, more on treatement https://t.co/oAFcGlOU2y

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