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Comparing EULAR (2025) and ACR (2020) Guidelines on Safety of Lupus Medications in Pregnancy
Attendees at the 2025 RheumaPreg meeting were excited to discuss the newly released EULAR recommendations for use of antirheumatic drugs in reproduction, pregnancy, and lactation. Table 1 summarizes the major recommendations from EULAR (2025) and the American College of Rheumatology (2020) reproductive guidelines for commonly used medications in SLE. It should be noted that these two sets of guidelines largely align, however, the updated EULAR guidelines have included some additional medications incorporating data from the last five years.
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SLE Perspectives: Past, Present, Future
From fellowship through current times to looking ahead to the future, here are my lupus perspectives.
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Vitamin D Headlines (5.9.2025)
Dr. Jack Cush reviews the news, journal reports and lupus highlights from the past week on RheumNow.com. Triple positivity, the gut and CRPS, and hope for better outcomes with Vitamin D therapy.
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Emulation trials in SLE: Real or Fake?
Recently a landmark paper was published in A&R studying the results of an emulation trial on SGLT2i (sodium-glucose co-transporter 2 inhibitors) showing benefit in SLE patients with diabetes mellitus (DM), for both renal protection and reducing cardiovascular events, using data from an American large insurance claim database. My colleagues and I were able to write an editorial on this paper and describe emulation trials.
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Betw 2005 -2021, there was a substantial increase in HCQ use, but only modest steroid (GC) reductions. Swedish cohort study of 3891 SLE pts - over 5 yrs GC decr from 68% - 54% to 46%. HCQ increased by 29% over 5 years. https://t.co/sI7JWq3AGk https://t.co/RBUMcl8uGz
Dr. John Cush RheumNow ( View Tweet)
Emulation trials in SLE: Real or Fake?
Recently a landmark paper was published in A&R studying the results of an emulation trial. My colleagues and I were able to write an editorial on this paper and describe emulation trials.
https://t.co/0ulYG5xz0J https://t.co/8oj8UDV9Dd
Dr. John Cush RheumNow ( View Tweet)
New Steroid Rules in Lupus? Let’s Talk.
Dr. Michelle Petri breaks down the latest strategies to minimize steroid exposure while managing disease activity in lupus patients.
💡 Smarter steroid use = better outcomes.
👉 Watch now on RheumNow:
https://t.co/vbjrXAlixz
#Lupus https://t.co/04CjTkCqMJ
Links:
Dr. John Cush RheumNow ( View Tweet)
Telitacicept, recombinant fusion protein targeting BLyS & APRIL, studied in 41 Chinese SLE pts (added to standard Rx) showed mean improvements in SLEDAI-2K (10.0 to 6.25 @12 wks & 4.2 @24 wks;p<.001), daily prednisone (21 mg to 9.8mg) & proteinuria (2.8 gr to 1.3 gr/day) https://t.co/KHMWPeq79x
Dr. John Cush RheumNow ( View Tweet)
Tuesday Night Rheumatology: 🔓 Lupus Unlocked: Cutaneous SLE
Join us for a discussion of the diagnosis, management, and latest insights into cutaneous manifestations of SLE.
Featuring:
Dr. Victoria P. Werth
Dr. Matilda Nicholas
Dr. Anthony Fernandez
Dr. Christopher Richardson https://t.co/UNazbo9TuZ
Dr. John Cush RheumNow ( View Tweet)
Retrospective study of 131 childhoold SLE pts found lymphopenia (in 53%) significantly correlated w/ higher anti-dsDNA and increased disease activity. (r = −0.63). Lymphopenia assoc w/ more nephritis (72%), HTN (24%), leukopenia (36%) & neuropsychiatric SLE https://t.co/ONUm84jThE
Dr. John Cush RheumNow ( View Tweet)
More Women with Autoimmune Diseases Die from Cardiovascular Disease
Women with the autoimmune diseases rheumatoid arthritis, lupus or systemic sclerosis may have a higher rate of death related to cardiovascular disease than men with the autoimmune diseases, according to new https://t.co/Px9ayANsFL
Dr. John Cush RheumNow ( View Tweet)
Certolizumab effective in preventing adverse pregnancy outcomes in high-risk antiphospholipid syndrome. CZP given to 51 APS pts wks 8 to 28. 9 w/ primary APO (17.6%) (6 w/ pregnancy loss <10 wks) - significantly lower than historical controls. Median delivery 36.5 wks. Neonatal https://t.co/KfOOM7sEAt
Dr. John Cush RheumNow ( View Tweet)
Lupus QD Clinic - Polar Opposite Approaches for Lupus
Dr. Eric Dein, Summit, New Jersey, presents SLE QD Clinic: Polar Opposite Approaches for Lupus.
https://t.co/sGcYmo8gWs https://t.co/3hrYC6ATBy
Dr. John Cush RheumNow ( View Tweet)
Hyperpigmentation in SLE
Young complex SLE patient develops blue-grey/slate colored hyperpigmentation on her arms and legs - From?
Features Dr. Jack Cush
https://t.co/yoKU7rJp8y https://t.co/Kh0tZLJ8SX
Dr. John Cush RheumNow ( View Tweet)
Tuesday Night Rheumatology: 🔓 Lupus Unlocked: Cutaneous SLE
Join us for a discussion of the diagnosis, management, and latest insights into cutaneous manifestations of SLE.
Featuring:
Dr. Victoria P. Werth
Dr. Matilda Nicholas
Dr. Anthony Fernandez
Dr. Christopher Richardson https://t.co/w7cYVNUI9t
Dr. John Cush RheumNow ( View Tweet)
Retrospective study of 131 childhoold SLE pts found lymphopenia (in 53%) significantly correlated w/ higher anti-dsDNA and increased disease activity. (r = −0.63). Lymphopenia assoc w/ more nephritis (72%), HTN (24%), leukopenia (36%) & neuropsychiatric SLE https://t.co/F1NALw86hu
Dr. John Cush RheumNow ( View Tweet)
Full read review of Neuropsychiatric SLE. NPSLE criteria includes 12 central & 7 peripheral findings (psych, cognitive, Sz, CVA/TIA, neuropathy, MS-like). NPSLE AutoAbs are many: Abs against APL, LAC, RP, NMDA, NMO/AQP4, EC, SBSN, UCH-L1, TP1, GAPDH, MAP2, U1RNP https://t.co/1m7SXMA68Z
Dr. John Cush RheumNow ( View Tweet)
Prophylaxis Against PJP in SLE: I'll Pass with @EBRheum
https://t.co/tUGwziEYCg https://t.co/VqTa9jG8oj
Dr. John Cush RheumNow ( View Tweet)
Stable SLE - Should you Withdraw Immunosuppressant or Glucocorticoids?
An open-label, single-centre, randomized controlled trial tested whether immunosuppressant (IS) withdrawal is noninferior to glucocorticoid (GC) withdrawal in SLE patients and found that IS withdrawal is https://t.co/T8Fu83GScH
Dr. John Cush RheumNow ( View Tweet)
Glucocorticoids in SLE: how to start, how to follow, how to stop
More than 70 years after their first use in rheumatology by Philip Hench, glucocorticoids (GCs) continue to be one of the main weapons to fight systemic lupus erythematosus (SLE). No other available medication https://t.co/H6N0N3BhhU
Dr. John Cush RheumNow ( View Tweet)
