Mariette and colleagues have reported on the prospective pharmacokinetic study of placental transfer of certolizumab pegol (CZP) from pregnant women to their infants at the time of birith.

 Researchers have reported their case-control study using the Swedish Epidemiological Investigation of RA study (2641 cases/4251 controls) to examine  the influence of oral contraceptive (OC) use or breastfeeding on the risk of rheumatoid arthritis (RA). 

The RheumNow Week in Review discusses the past week's news, journal articles and highlights from RheumNow.com. In this week's report, Dr. Jack Cush discusses presentations from APLAR 2017 in Dubai, Catastrophic APS, safety of low-dose prednisone, frequency of psoriatic arthritis and a new drug for PsA and a hepatitis A outbreak in San Diego.

In the UK, NICE has accredited the British Society of Rheumatology (BSR) to develop a guidance document on the management of systemic lupus erythematosus in adults.  The last published guidelines for lupus were published in 2008 by EULAR and in 2012 by the ACR.

The RheumNow Week in Review discusses the past week's news, journal articles and highlights from RheumNow.com. In this week's report, Dr. Jack Cush discusses when to hold the biologic, lymphoma risk with tofacitinib, early clues to the diagnosis of RA, biologic use in pregnancy, what's killing psoriasis patients and the 2016 top 5, best selling drugs in rheumatology.

While it is highly desirable to avoid medications during conception and pregnancy, statistics show that >90% of women take at least one drug during pregnancy and nearly half will take 3 or more medications during pregnancy.

Opioid overdose deaths quadrupled from 1999 to 2015 and accounted for 63% of drug overdose deaths in the United States in 2015. During 2010–2015, heroin overdose deaths quadrupled from 3,036 to 12,989, with heroin and illicitly manufactured fentanyl (IMF) as likely contributors to this trend.

Dr. Jack Cush reviews new FDA decisions on sirukumab and tofacitinib as well as other news items from the past week on RheumNow.com. 

While there are several reports detailing uncontrolled, observational results of biologic use during pregnancy, most are hampered by low numbers, incomplete data and too small a sample to make reliable judgements regarding the teratogenicity.  A company sponsored claims data analysis has shown that etanercept exposure during pregnancy was not associated with an increase in major congenital malformations (MCMs).

Dr. Jack Cush reviews the news from the past week on RheumNow.com: 

A population-based claim study from Sweden has shown that lupus and pre-lupus patients are at risk for adverse maternal and fetal outcomes.   

The U.S. Food and Drug Administration (FDA) has approved the IL-23 inhibitor, Tremfya (guselkumab), for patients with moderate to severe plaque psoriasis.

It is a common practice for rheumatologists to discuss medication-related teratogenicity and disease implications in case of pregnancy.  Yet, discussion of breastfeeding are often omitted.

Young patients with systemic lupus erythematosus (SLE) get diagnosed before they have completed their families. About 30 or 40 years ago, most rheumatologists were not recommending pregnancy for their lupus patients. However, in recent times, outcomes have considerably improved.

Dr. Jack Cush reviews highlights from the past week on RheumNow.com. 

Despite the folklore, not all women with arthritis who become pregnant will improve or go into remission.  Recent studies have suggested that up to one-third of RA patients will flare during pregnancy.

Low rates of serious infections were observed in pregnant women receiving immunosuppressive therapies. Higher rates may be seen with steroid use in pregnancy and SIE trend towards lowest with DMARD or TNFi use. 

Dr. Jack Cush reviews news and highlights from the past week on RheumNow.com.  Sign up at RheumNow.com to received daily or weekly news, blogs and tweets on all things rheumatology

On the heels of the recently published EULAR recommendations for the management of pregnancy in patients with systemic lupus erythematosus (SLE) and the anti-phospholipid syndrome (APS) comes a new meta-analysis published in the Journal of Autoimmunity on pregnancy outomes in lupus.

There is a significant unmet need with regard to counseling and managing SLE and APS patients who become pregnant or who may be planning for pregnancy.