2020 was historic, memorable and game-changing. Under the cloud of COVID-19, there were many significant and memorable advances and setbacks for the rheumatology world. In our accounting of most read articles for 2020, (not surprisingly) 17/20 were COVID-related.

According to a recent report in Annals of Rheumatic Disease, public enthusiasm for hydroxychloroquine (HCQ) created significant access issues for rheumatic patients in the early phases of the COVID-19 pandemic.

UK Clinical Practice Research Datalink population study shows that patients with immune-mediated inflammatory diseases, such as RA, PMR, GCA and IBD, have an augmented risk of CV outcomes with glucocorticoid use; even lower doses had a near doubling of their underlying CVD risk.

Recurrent pericarditis is a rare, probable autoinflammatory disorder mediated by interleukin-1 (IL-1); and is often refractory to glucocorticoids and colchicine.

The ACR has published guidelines to manage reproductive health issues in rheumatic disease (RMD) patients before, during and after pregnancy. In this second excerpt from their guidelines articles, we present recommendations (and good clinical practice statements) for paternal rheumatology medication use by men with RMD and on conventional rheumatology medications and biologic use in pregnancy for women with RMD. 

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.

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.