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RA: update for women of child bearing potential (and men!) Fertility in the context of RMDs is a daily concern for a lot of rheumatologists and patients. https://t.co/RrkR2V3CI3 https://t.co/CRXUKxUqF2

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Dr. John Cush RheumNow ( View Tweet)
couple holding hands with baby shoes

RA: update for women of child bearing potential (and men!)

d Aurelie Najm, MD, PhD

Fertility in the context of RMDs is a daily concern for a lot of rheumatologists and patients.

EULAR this year proposed new fertility data, especially in Rheumatoid Arthritis, along with an update of the EULAR points to consider for use of antirheumatic drugs in reproduction, pregnancy and lactation.

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Is a Biomarker for Adverse Pregnancy Outcomes on the Horizon? Pregnancy in lupus patients raises concerns due to potential complications like preeclampsia, eclampsia, and increased mortality rates for both mother and baby. https://t.co/Kv6F21UHze https://t.co/ya8lAkSLC2

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Dr. John Cush RheumNow ( View Tweet)
Have RA and want to get pregnant? What can you do? The answer is simple: disease control. Implementing T2T in RA led to much better fertility. RA therapy is your friend! #EULAR2024 POS0436 Rotterdam @RheumNow https://t.co/aoxNakMix1

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David Liew drdavidliew ( View Tweet)
T2T strategy in RA during pregnancy improves time to procreate Results PreCARA (T2T median DAS28CRP 2.33) vs. PARA median DAS28CRP 3.84) median TTP 84d vs. 196d TTP exceeded 12 months in 23% of PreCARA pts compared to 42% in the PARA pts. @RheumNow #EULAR2024 POS0436 https://t.co/DfgEvvtCwR

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Aurelie Najm AurelieRheumo ( View Tweet)
Points to consider in pregnancy &lactation in Pts w #rheumatic #diseases #biologics don’t increase rate of serious infections in Mom Baby Compared to other matched pregnant and post partum women reassuring! #EULAR2024 @RheumNow @eular_org

Janet Pope Janetbirdope ( View Tweet)

What to use in men prior to planned conception of partner in #rheumatic #diseases #EULAR2024 ⁦@RheumNow⁩ ⁦@ACRheum⁩ ⁦@eular_org⁩ https://t.co/jMecV8jqUe

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Janet Pope Janetbirdope ( View Tweet)
pregnant, pregnancy, mother, fertility

Is a Biomarker for Adverse Pregnancy Outcomes on the Horizon?

d Bella Mehta, MBBS, MS

With a better understanding of pathophysiology, improved management guidelines, available medications, and a multidisciplinary approach, pregnancy for lupus patients has become more feasible. Despite these improvements, some patients still experience poor outcomes, highlighting the need for biomarkers that can predict these risks. An abstract presented at #EULAR2024 (POS1393) explored this possibility.

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Systematic Review of #SLE pregnancies in Latin America – 44articles, 4K patients, Hispanic/ Latino with increased preeclampsia when they have LN #EULAR2024 Abst#0986 @RheumNow

Bella Mehta bella_mehta ( View Tweet)

Kaiser/California EHR study of #SLE pregnancies (2011-2020) - 657 pregnancies in 453 prs; The live birth rate = 74%, 23% w/ Spontaneous Ab, 2% ectopic/molar & <1% stillbirths. Variable outcomes by race & ethnicity, aPL status & nephritis history https://t.co/gvmYpTuFon https://t.co/9TeG8kfLmK

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Dr. John Cush RheumNow ( View Tweet)
FDA issued a drug safety warning linking thiopurine (AZA, 6MP) use in pregnancy & a rare risk of intrahepatic cholestasis of pregnancy (ICP). ICP has been reported in pts w/ CD, UC, or SLE; however thiopurines are not FDA approved for these Dx https://t.co/s37eRuAtQx

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Dr. John Cush RheumNow ( 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

Dr. John Cush RheumNow ( View Tweet)

High risk medications for pregnancy: MTX- 40% pregnancy loss, 6-10% birth defects MMF/CYC - 40% pregnancy loss, 25% birth defects Recommend 2 forms contraception on MMF Change meds slowly to safe Rx and monitor disease activity at least 3 mos before pregnancy #RNL2024 @RheumNow

Dr. John Cush RheumNow ( View Tweet)

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1/600 Falls May Die (4.5.2024)

d Jack Cush, MD

Dr. Jack Cush reviews the news and Journal reports from this past week on RheumNow.com -  including problems w/ falls, pain and treatment of Dupuytren’s contractures.

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Activity & Pain Tolerance (3.29.2024)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com, including where you should sit in clinic and why you should worry about secondary Sjogren's in RA.

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pregnancy,embryo,fetal

Higher Rates of Childlessness in Rheumatic Diseases

d Jack Cush, MD

A large Finnish population study shows that several rheumatic diseases may impair reproduction and pregnancy outcomes, with significantly higher rates of childlessness or fewer children overall for women.

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Naysayers & Disrupters (3.22.2024)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week - including a few contrary reports on infection, seropositivity and plasmapheresis.

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1st trimester exposure to Plaquenil is not assoc. w/ risk of congential malformations (MCM). Swedish registry data on 1007 births (453 exposed) & 2500 births (144 exposed) in SLE & RA, respectively. MCM risks in SLE &RA were 3.4-5.7%, no diff betw groups https://t.co/lzbd7AQqy1 https://t.co/AsFYYBQQtm

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Dr. John Cush RheumNow ( View Tweet)
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Ides of March (3.15.2024)

d Jack Cush, MD

Dr. Jack Cush has advice for Caesar and the superstitious, and covers pregnancy, platelets, dialysis and vaccinations in Lupus.

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Japanese study of 96 #SLE pregnancies: 59 in remission @ conception. Remission had fewer adverse preg outcomes (OR 0.27) vs those w/ activity. No difference in APO based on serologies, but Pred ≥7.5/d us had signif. more APO. (OR 3) https://t.co/BvOeiSERN9 https://t.co/ePh1dqdJvS

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Dr. John Cush RheumNow ( View Tweet)

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