A lot of interesting studies will be presented at the poster sessions on Sunday, November 12 and some of them address practical real-world issues such as treatment intensification and the impact of pregnancy on axSpA imaging.
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ACR Convergence is truly drinking from the proverbial fire hose. It’s a beautiful mash-up of basic science and treatment updates meets guidelines, recommendations, and disease identification.
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Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com. This week highlights Veterans, Vegetarians and Antenatal Corticosteroids.
Aurelie Najm
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CV events in women w/ ARDs pregnancies:
-2.0% of 19,340 pregnant ARDs
Adjusted relative risk:
-4 fold in ARD
-15 fold in primary APS
-6 fold in SLE
-SLE + APS 18 fold
25-30% occur in early post partum!
Need for continued vigilance after delivery
@RheumNow #ACR23 ABST0722 https://t.co/hLeN61WBnB
CVE’s higher in pregnant pts with SLE + APS, primary APS and Lupus nephritis especially in the postpartum period. Rheums need to be involved with their patients’ care during pregnancy! Abstr#0722 #ACr23 @rheumnow https://t.co/P6sbJtd6xW
Robert B Chao, MD
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Always great to see UCSD represent at #ACR23!
Pregnant women with rheumatic diseases and antiphospholipid syndrome higher a HIGHER risk for acute cardiovascular events
30% of events occurred postpartum
@RheumNow Abs#0722 https://t.co/CqZedfOlBC
Bella Mehta
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Plenary 1 #ACR23
CVE in ARD/APS is a significant risk factor during pregnancies and the risk stays even after delivery for a significant amount of time. California based administrative data study! abst#722 @RheumNow https://t.co/HawhS4Gqko
Janet Pope
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Should all of active moms with #SLE receive DVT prophylaxis post partum? High rates of VTE in #ARDs post partum #0722 #ACRbest #ACR23 @RheumNow @ACRheum Likely data driven by #SLE and maybe #RA and not all #autoimmune #rheumatic #disease. Large pop’n data from California https://t.co/sGJa5N6HUj
Plenary talk by Dhital etc al, shows increased risk of acute CV events in pregnant rheumatic, SLE, APS pts, esp if nephritis or APL+. #ACR23 Abstract 0722 https://t.co/pG0PqzVtIU
sheila
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Analysis from the DESIR cohort reveal that pregnancy does not aggravate imaging changes in axSpA.
Stat significant changes seen on Xray of LSIJ b4 & after delivery (p=0.037) but not worsening.
Do these findings also translate to⬇️pain/improved QOL?
#ACR23 ABST0513 @RheumNow https://t.co/s6xD2CaPwn
Robert B Chao, MD
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Does pregnancy affect axSpA imaging?
Large study of 381 pts, in the DESIR cohort, f/up of 5 years.
Pregnancy did not aggravate imaging of axSpA women compared to prior to pregnancy.
@RheumNow #ACR23 Abs#0513 https://t.co/eeGuxGGB5E
Dr. Rachel Tate
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#ACR23 Abs 0465 suggests changes in rheums’ rx patterns in context of nationwide abortion restriction, particularly in abortion-restricted states; reproductive-age female pts may have less access to EB treatments like MTX/MMF for rheum dz. https://t.co/QN9C4PjUaN
@rheumnow
We gotta do better! Reproductive health counseling is poorly done- only a third rheumatologists surveyed ask pts about reproductive health: sexual activity, pregnancy desire, contraception. Abstr#0162 @_michgarcia @rheumnow #ACR23 https://t.co/r9tewu2I9N
Dr. Rachel Tate
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DESIR cohort update in Abs #0513 shows axSpA pt imaging doesn't "worsen" after pregnancy. However, following 1st pregnancy, can see slight increase in L SIJ score, but typically not enough to define "worsening." #ACR23 https://t.co/HaYj3RQGFb @rheumnow https://t.co/5MQCXS1Kat
David Liew
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Pregnancy is complicated for women with rheumatic diseases.
There's a pathway to healthy mothers & babies, but it takes:
- planning
- the right meds
- the right disease control.
@drbags71 #ACR23 Review Course @RheumNow https://t.co/epdDIVGPye
David Liew
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@drbags71 @RheumNow Too often we don't leave women of childbearing age with a plan, if they do get pregnant. And we need to help them get ready, for whatever they want, so we can avoid bad outcomes - and all the consequences of that.
@drbags71 #ACR23 Review COurse @RheumNow https://t.co/HLg6KjCiJX
David Liew
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@drbags71 @RheumNow So approach @drbags71:
HOP-STEP
- proactively ask/communicate
- make difficult discussions easier with these truly amazing guides:
https://t.co/9AJIrF9bsQ counselling
https://t.co/618mrifi3f dr/pt Rx plans
⬆️**bookmark these**
- share
do not miss!
#ACR23 Review Course @RheumNow https://t.co/vWwJLu2HWG
"Reproductive right is a global issue"- @CuoghiE suggests what Rheums can do:
👉Advocate for legislation to help pts
👉Integrate family planning
👉Prescribe emergency contraception
👉Provide education about reproductive health
#GlobalSummit @ACRheum @RheumNow https://t.co/jLHpzJT2wf
Dr. del Carmen Zamora-Medina listed several reasons why rheum patients may seek #abortion: teratogenic meds, comorbidities, high disease activity, increased APOs, &women focused reasons. #ACR23 @GlobalSummit #ReproductiveRights @Rheumnow https://t.co/CaH9GVfVvY
342 systemic sclerosis pts, ~32% report reproductive probs:
-early menopause onset (45 vs 48y)
-menopause effected by SSc onset & digital ulcers
-More spont Abs(12 vs 4%), premies (22 vs 6%), low birth Wt (27 vs 5%), C-section (49 vs 19%); NOT Infertility https://t.co/Tjjl9sxtja https://t.co/LKzyGR0mlE


