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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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ACR 2020 Reproductive Guidelines - Medication Use with Pregnancy

d Jack Cush, MD

The American College of Rheumatology (ACR) has published guidelines to manage reproductive health issues in rheumatic disease (RMD) patients before, during and after pregnancy.

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ICYMI - 11 Pearls for Pregnancy Management in Rheumatoid Arthritis

d Artie Kavanaugh, MD,  , Jack Cush, MD

Rheumatoid arthritis affects women in their child-bearing years and many will face the issue of pregnancy and RA management at some point. Here are11 considerations for those managing RA patients who wish to become pregnant.



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Free full read review "Postnatal Care of Woman with Rheumatic Dz". 46% of RA pts will flare postpartum; breast feeding is ok w/ most biologics; Hold Live vaccines if Pt is on a biologic during pregnancy; VTE prophylaxis essential for 10 d–6 wks postpartum. https://t.co/Ol23S0GiEW

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QD Videos from RheumNow Live. "I wanna get pregnant" (a controlled RA patient on tocilizumab) https://t.co/vfLgQPrl98

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Dr. John Cush RheumNow ( View Tweet)

Case series compared 247 pregnancies in IgA Vasculitis patients vs 556 control pregnancies showing IgA Vasculitis had no effect on fertility and did not induce flares. But IgAV had more spont. abortions, gestational HTN, preterm delivery. https://t.co/CCG2v6sMe1

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296 women with HTN during pregnancy (half/147 NSAID-exposed) - NSAID use was not associated with a significant change in BP (vs no NSAID) and there was no added need to start or increase BP meds in those on NSAIDS. https://t.co/g56xgQEPjr

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Dr. John Cush RheumNow ( View Tweet)

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ACR 2020 Reproductive Guidelines - Contraception & Counseling

d Jack Cush, MD

The American College of Rheumatology established a guidelines committee that consisted of both patients, rheumatologists and maternal-fetal health experts. After a a systematic review of the medical literature regarding contraception, assisted reproductive technology, fertility preservation, hormone replacement therapy pregnancy, lactation, and medication use in rheumatic disease patients, they published 12 good practice statements and 131 recommendations for reproductive health care in RMD patients.

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Metanalysis of 10 studies and 204 RA patients suggests that during pregnancy disease activity improved in 60% of patients but flared post-partum in nearly half (47%). https://t.co/FgzH6ifU4Y

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Analysis of Natl Inpatient Sample database (1998-2014) compared outcomes in 87605 SLE pregnancies vs matched cohort: found SLE had more C-section, IU fetal death, Pre-eclampsia, VTE, CKD, HTN, longer stays Presented by Dr. Bella Mehta #ACR18 Abst 1852 https://t.co/HJvs1D0zhD

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#ACR18 @rheumnow abs 2419. In a busy clinic, ask 'one key question' as a way to opening discussion on pregnancy planning in SLE. With an EPR it can even come up as a prompt on your screen. https://t.co/Y1hp7ILB2N

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Dr. John Cush RheumNow ( View Tweet)

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RheumNow Podcast – The Bad News That’s Fit to Print (8.21.20)

d Jack Cush, MD

Dr Jack Cush reviews the news and journal reports from the past week on RheumNow: filgotinib rejection, delays in diagnosis, metformin benefits COVID, Abx and IBD, and UPA beats MTX.

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Single center prospective study of 50 severe SLE pts (age 31 - 28 yrs) Rx with either mycophenolate or IV CTX. Ovarian dysfunction was short lived and subclinical w/ CTX. No premature ovarian failure seen w/ CTX. No ovarian dysfunction w/ MMF. https://t.co/qvc3i6TNB1

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Dr. John Cush RheumNow ( View Tweet)

Dannish registry study of 2.6 million pregnancies, finds spontaneous abortion risk was increased in women <35 yrs with RA Dx <5 yrs before pregnancy (OR = 1.25; 1.07, 1.48), but not in RA women >35 or w/ preclinical RA (compared w/ non-RA) https://t.co/fAxvfYOQcJ

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Dr. John Cush RheumNow ( View Tweet)

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RheumNow Podcast – LTF – Listen to Fauci (7.17.20)

d Jack Cush, MD

Dr. Jack Cush reviews the news, tweets and journal articles from the past week on RheumNow. Let's dig into this week's 14 highlights.

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RheumNow Podcast is Up! Listen to Fauci! Watch it here>> https://t.co/dHq3fP85Ip or Listen to the Podcast>> https://t.co/LdHO7fKUCp

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Dr. John Cush RheumNow ( View Tweet)

RheumNow Podcast is Up! Listen to Fauci! Watch it here>> https://t.co/dHq3fP85Ip or Listen to the Podcast>> https://t.co/LdHO7fKUCp

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Dr. John Cush RheumNow ( View Tweet)

MMWR reports 2019 survey data showing 6.6% of women used opioid during pregnancy. 21% admitted misuse, 27% wanted to stop/reduce narcotic use and 32% did not receive MD counseling about how opioid use could affect an infant. https://t.co/Ybrjv4Anmk

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Dr. John Cush RheumNow ( View Tweet)

The RheumNow Podcast is Up! Lupus Mortality Declines, But… Review of SUA and cancer; IL-12/23 and SLE; TCZ and Behcets, Pregnancy SI MRI, VTE w/ Jaks; COVID; Colchicine. Watch it here> https://t.co/2V7TbaAsOp or listen on iTunes or SoundCloud https://t.co/XMps2GTgeD

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Dr. John Cush RheumNow ( View Tweet)

The RheumNow Podcast is Up! Lupus Mortality Declines, But… Review of SUA and cancer; IL-12/23 and SLE; TCZ and Behcets, Pregnancy SI MRI, VTE w/ Jaks; COVID; Colchicine. Watch it here> https://t.co/2V7TbaAsOp or listen on iTunes or SoundCloud https://t.co/XMps2GTgeD

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Dr. John Cush RheumNow ( View Tweet)

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