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We can do our best to optimize them for the best possible pregnancy outcomes?
1. Confirm pregnancy goals/timeline
2. Discuss patient’s disease activity over the past 12 mo
3. Document end organ damage and the last time this was assessed
4. Review medications
5. Check… https://t.co/7xQsGW9dKa
Dr. Rachel Tate uptoTate ( View Tweet)
"The most successful pregnancies are planned during periods of well controlled disease on pregnancy compatible medications." Dr. C Sims #RNL2024 @RheumNow @DrCassySims
Dr. Rachel Tate uptoTate ( View Tweet)
Rheumatology drugs in pregnancy. Just missing leflunomide in that big no no section @DrCassySims @RheumNow #RNL2024 https://t.co/ZPtTGRqPki
Richard Conway RichardPAConway ( View Tweet)
@DrCassySims: the Pregnancy Checklist for #Vasculitis patients @rheumnow #RNL2024 #ReproductiveRheumatology
👉confirm pregnancy goals
👉review meds, dz activity in the last 12 months
👉document end organ damage
👉assess Ro/La
👉discuss role of ASA
👉work w/ MFM/subspecialists https://t.co/5z4XeMRzGI
TheDaoIndex KDAO2011 ( View Tweet)
Pregnancy in vasculitis checklist:
- goals and timeline
- disease activity in 12 mos
- is there end organ damage?
- Review Rx
- h/o clots/miscarriages, APLS?
- Check Ro/La
- Role for ASA?
- Refer to MFM
Catherine Sims #RNL2024 @RheumNow
Eric Dein ericdeinmd ( View Tweet)
How do vasculitis pts do during pregnancy?
Variable due to different diagnoses of flares
Gatto 2012: TA 3% flare, GPA 45% flare
Fredi 2015: 35% flare
Nguyen 2021: LVV 25% flare, 36% SVV
-Catherine Sims
#RNL2024 @RheumNow
Eric Dein ericdeinmd ( View Tweet)
2nd kidney biopsy in lupus nephritis have value. @andreafava
#RNL2024
@RheumNow https://t.co/47J1CGQL81
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
#RNL2024 day 2:
- Vasculitis Pod with @anisha_dua and @philseo
- STEP talks: @DrLisaCS on myositis malignancy screening, @EBRheum on ANCA myths, @RheumNow dead words in rheum
- Spondy Pod with @JointMD @lihi_eder @LianneGensler
Eric Dein ericdeinmd ( View Tweet)
Proteinuria doesn’t correlate with internal activity in lupus nephritis , we really need better biomarkers.
@andreafava
#RNL2024
@RheumNow https://t.co/bFuxVnUCEB
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
This is a crucial nuance. Men and women experience pain differently. The tendency to use that to then dismiss pain in women is entirely incorrect. @lihi_eder @RheumNow #RNL2024 https://t.co/X5QQsaIuNP
Links:
Richard Conway RichardPAConway ( View Tweet)
Dr. Gabalawy: "How do you know what disease patients will develop in this preclinical autoimmunity state?"
@drdavidkarp "it's like when weeds pop up in a garden, it's random ...if ACPA Ab pops up, you might have RA, if it's dsDNA, maybe lupus." #RNL2024 @RheumNow https://t.co/JmDtaTt3sU
TheDaoIndex KDAO2011 ( View Tweet)
Great talk -this is a summary slide on lupus nephritis and biomarkers to predict renal survival. When you get a chance, you have to watch @andreafava on #RNL2024 https://t.co/3PgFWCU9n6 @RheumNow https://t.co/AZNq9XrTMx
TheDaoIndex KDAO2011 ( View Tweet)
Combining results of urinary IL16, PR3, CD163 at 12 months best predicts kidney function protection at 3 years - @andreafava #RNL2024 @rheumnow https://t.co/0XV0MrhL1F
TheDaoIndex KDAO2011 ( View Tweet)
Low urine IL-16 at 12 months predicted kidney survival much better than proteinuria. Check out AUCs in the this first slide. Dr. @andreafava reviews this potential biomarker. Question if this could also be a possible target for treatment as well?
#RNL2024 @RheumNow https://t.co/cCLRERVXmq
Links:
Dr. Rachel Tate uptoTate ( View Tweet)
Low urinary IL16 levels at 12 months predicts kidney suvial at 3 years better than proteinuria - @Andreafava @rheumnow #RNL2024 https://t.co/AEaL8n2nv8
TheDaoIndex KDAO2011 ( View Tweet)
@andreafava @jhrheumatology
Urinary biomarkers (CD163, IL-16) at 3 months predict the 1 year response better than UPCR
- At 6 & 12 mos predicts renal survival at 3 yrs
- At 12 mos: IL-16 92% accurate, sens 97%, Spec 80% vs UPCR 72% accurate, 75% sens, spec 67%
#ACR2024 @RheumNow https://t.co/YtbCrwrch0
Links:
Eric Dein ericdeinmd ( View Tweet)
Scary! A third of patient with lupus nephritis who are considered complete respondues continue to aaccrue progressive renal damage - @Andreafava @rheumnow #RNL2024 https://t.co/mhu3YoY3YV
TheDaoIndex KDAO2011 ( View Tweet)
1/3 of lupus nephritis patient classified as "complete responders" continued to accrue progressive renal damage despite resolution of proteinuria over 1 year.
Dr. @andreafava reviews GFR trajectories after renal bx at #RNL2024 @RheumNow https://t.co/nYJZWw9jUL
Dr. Rachel Tate uptoTate ( View Tweet)
Myeloid and neutrophil degranulation is involved in disease activation of lupus nephritis. IL16 and CD163 are urinary biomarkers correlating with histologic disease activity “- Dr. @andreafava #RNL2024 @rheumnow https://t.co/YffIRy8B9u
Links:
TheDaoIndex KDAO2011 ( View Tweet)
Urine proteomics in lupus nephritis
IL-16 and CD163 are urinary biomarkers most correlated w/ histologic activity
Myeloid & degranulation sign ass w histo activity -> PR3+cells abundant in LN
@andreafava #RNL2024 @RheumNow https://t.co/AVkZxPXkw3
Eric Dein ericdeinmd ( View Tweet)
