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Dr. Jack Cush reviews and discusses the news and journal reports from the past week on RheumNow.com.
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HCQ is one of the safest meds used in rheumatology, but new claims data suggests a small increase in the risk of malformations associated with first-trimester HCQ use. The March 2021 issue of the American Journal of Obstetrics and Gynecology studied the risk of major congenital malformations during the first trimester of pregnancy in women with rheumatic disease taking HCQ.
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There's good news and bad news in rheumatology fellowship matching for 2022. There's also new FDA approvals and indications, but a new serious safety warning has arisen from the CDC about the J&J COVID-19 vaccine.
Dr. Jack Cush reviews the latest news, journal reports, regulatory approvals, plus 3 new cases from rheumatologists.
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Little is known about the safety of newer biologic use during pregnancy, especially in patients who either conceive while on a biologic or must remain on a biologic during pregnancy (often the case with IBD and inflammatory arthritis).
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The RheumNow faculty have been glued to their monitors all day, watching video, and running down abstract presentations to find the best – several of these stood out as #ACRBests. Here is a listing of “Best” they saw on Day 1.
Dr. John Cush
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Pregnancy Outcomes in PsA, SpA, RA: Dr. Rachel Tate ( @uptoTate) reviews abstracts #0369, #1722 and #1730 presented at the ACR21 annual meeting.
https://t.co/kUQReWtEdO https://t.co/MZ9Fe1Ms3N
Dr. John Cush
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Infection Risk in Offspring Exposed to Biologics: Dr. Rachel Tate ( @uptoTate)
https://t.co/oYpKpCix7Q https://t.co/0yIk9Qhc1h
Meral K. El Ramahi, MD
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SpA & Pregnancy Outcomes?
➡️SpA pts txed w/ bDMARDs at conception are not at higher risk for adverse pregnancy outcomes compared to those w/o bDMARD
➡️Stopping bDMARDs after conception assoc w/ ↑ dz activity during pregnancy + after birth & ↑flares
Abst#1730 #ACR21 @RheumNow https://t.co/Y4c7vI0cgS
Dr. Rachel Tate
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RHEKISS registry: SpA pts on bDMARDs at conception are NOT at inc. risk for adverse pregnancy outcomes. Discontinuation of bDMARDs after conception is assoc'd w/ inc. dz activity during/after pregnancy & flare risk. Abs 1730 #ACR21 #RheumNow @RheumNow https://t.co/b2wI9GZios https://t.co/wsuvv3hF0v
Dr. Rachel Tate
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Pregnant pts w/ PsA, but not AxSpA, at increased risk of pre-eclampsia. In RA pregnancies, pre-eclampsia risk increases w/ dz severity prior/during pregnancy. We need to discuss potential risks w/ pts and OB team. Abs 1722 #ACR21 #RheumNow @RheumNow https://t.co/yeQmNAZ1jV https://t.co/cBfeVKQHfr
Dr. Rachel Tate
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No clear excess risk for offspring exposed in-utero to, VED or TNFi's. UST showed infection signal BUT w/ wide CIs. We need more research re: biologics and placental transmission potential/subsequent risks. Abs 1713 #ACR21 #RheumNow #ACRbest @RheumNow https://t.co/W3K5uDyHlC
Md Yuzaiful Md Yusof
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#ACR21 #Abstr1492 Could gut microbiome contribute to Anti-Ro+/autoimmunity in #lupus? Analyses of 125 stool samples from mother of children with neonatal lupus and/or heart block revealed its potential role in genetic-environment interaction @RheumNow https://t.co/FnJtZJSCRj https://t.co/ttRdP9NIrG
TheDaoIndex
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Meds men with rheum dz can use while trying to getting their partners pregnant #acr21 @RheumNow https://t.co/RlcPakappk
Veena Katikineni
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Review of ACR Reproductive Guidelines by Dr. Talabi
#ACR21 #ACRAmbassador https://t.co/x2xCSnxpJ2
Dr. Rachel Tate
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"Healthier moms lead to healthier babies. This is how I frame the discussion regarding medications and PsA in my practice (with regard to reproductive health)." Dr. Talabi #ACR21 @RheumNow #RheumNow
TheDaoIndex
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Dr B Bermas noted AAP guidelines say avoid MTX while breastfeeding, but the literature show very little MTX crosses breast milk. Dr Sammaritano stated that is true, but we don’t know how much MTX accumulates,though. #acr21 @rheumnow @UTSWRheum https://t.co/9I7HszorEO
TheDaoIndex
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Would you allow a pt to continue MTX while breastfeeding? #acr21 @rheumnow
Donald Thomas, MD
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#ACR2021 Dr. L Sammaritano shows evidence for using belimumab during breastfeeding @RheumNow https://t.co/kDXXauoOZQ
Donald Thomas, MD
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Remember: IUDs are the easiest contraception to recommend to SLE patients... Sammaritano lecture going on now #ACR2021 @RheumNow https://t.co/ZGRFIZyf5h
Robert B Chao, MD
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Irish registry of AS pts included 76 women who were pregnant
⭐️58% uncomplicated, 41.9% complicated, 11% multiple complications
⭐️frequency of miscarriage ⬆️
⭐️complications included C-section, preterm, NICU admission
#ACR21
@RheumNow
Abs#369 https://t.co/90dolEeTIw
