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Healthy mother = healthy baby
Pregnancy and neonatal complications linked to disease activity and inflammation
@RheumNow #RNL2022 https://t.co/MeBnYnSfuK
Robert B Chao, MD doctorRBC ( View Tweet)
TNFi and pregnancy
No association w/ congenital anomalies/infant infection
Discontinuation of TNFi before wk 24, increases risk of disease flare
Biologic lvls low in breast milk
Does not affect vaccine response
Live rotavirus vaccine did not cause infection
@RheumNow #RNL2022 https://t.co/ZNdjf5qNDb
Robert B Chao, MD doctorRBC ( View Tweet)
#ClinicalPearl You really are what you eat! Guy micobiome is ‘off’ in animal 🦒 & human studies in #inflammatory #arthritis compared to healthy population. But is it 🐓 or 🥚? Possibly both. @JoseScher @RheumNow #RNL2022 https://t.co/6nKsovlSgf
Janet Pope Janetbirdope ( View Tweet)
Ok 💩 results #ClinivalPearl one fecal transplant in active #PsA did WORSE than sham Rx. Those doing high colonics - no idea why one would- likely also a waste {pun intended} Dr Jose Scher presented RCT #RNL2022 @RheumNow https://t.co/FDlOvPdzvl
Janet Pope Janetbirdope ( View Tweet)
If you don’t treat active #rheumatoidarthritis while woman 👩 is pregnant, you may do more harm to 👶🏻. Look at the data @UmaMahadevanIBD #RNL2022 @RheumNow https://t.co/6P94IdfS15
Janet Pope Janetbirdope ( View Tweet)
ACR recommendations fro TNF biologics during pregnancy!
Why stop at third trimester?! i agree do not rock the boat!!
@UmaMahadevanIBD @RheumNow #Rnl2022 https://t.co/NEMEV3ThkF
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
Pregnancy exposure to biologics didn't increase risk of infection to THE FETUS !!
@UmaMahadevanIBD @RheumNow #Rnl2022 https://t.co/rdEaake6ey
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
Other data on TNF and pregnancy!
To maintain pregnancy and avoid complications , decrease inflammation! how? by continuing TNF!
▶️No increase risk of infection or vaccination response.
@UmaMahadevanIBD @RheumNow #Rnl2022 https://t.co/mcEMDzNlyH
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
What about live vaccines?! is there any increase risk of complications ?!
@UmaMahadevanIBD @RheumNow #Rnl2022 https://t.co/x74RoWNnLc
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
Pregnancy and Biologics
@UmaMahadevanIBD sharing excellent information on how stopping drugs can lead to more harm:
Lacking data that RA improves during pregnancy
Provider bias?
Steroids can increase complications in pregnancy
@RheumNow #RNL2022 https://t.co/jtCnD4wTag
Robert B Chao, MD doctorRBC ( View Tweet)
And finally, Day 1 will close out with POD 4: Spondyloarthritis Spectrum at 5pm ET. Join Dr. Philip Mease at his presentation on Axial Psoriatic Arthritis. #RNL2022 https://t.co/TInpHYteOx
Dr. John Cush RheumNow ( View Tweet)
#ClinicalPearl #Lupus nephritis is often now START w 2 immune suppressive & less total dose of #prednisone & May pulse w 500 mg solumedrol x3 instead of 1g. J Merrill #RNL2022 @RheumNow https://t.co/ePKkPHWhYJ
Janet Pope Janetbirdope ( View Tweet)
#ClinicalPearl Most ordering HCPs don’t know which #ANA is being performed when you order it. Lots of variability. Bottom line IF you DON’T have > moderate risk of #CTD DON’T order it. The FALSE + results will haunt your pt & you & cost 💰#RNL2022 @RheumNow https://t.co/uxMbAdOKcj
Janet Pope Janetbirdope ( View Tweet)
Why do we love to hate #guidelines in #rheumatology - maybe for example in #PsA we really don’t know the BEST Rxas 1st line advanced therapy & beyond. I say: Take a guess or do a pragmatic trial to figure it out. A Kavanaugh #RNL2022 @RheumNow https://t.co/lVIno6FBqJ
Janet Pope Janetbirdope ( View Tweet)
#RNL2022 Drs. Kavanaugh, Ogdie and Kirkham join Dr. Cush for the PsA panel Q & A. https://t.co/0ElGIe21S6
Dr. John Cush RheumNow ( View Tweet)
Cellular source of IL17 in SpA
Bruce Kirkham @RheumNow #Rnl2022 https://t.co/vDMks0RtBb
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
Synergetic effect of IL17 and TNF in PSA.
Bruce Kirkham @RheumNow #Rnl2022 https://t.co/acfqiluJWR
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
Dr. Bruce Kirkham
Drug Targeting in Psoriatic Arthritis
SEAM PsA study - MTX monotherapy not AS efficacious as MTX and TNFi combo therapy, but STILL effective
@RheumNow #RNL2022 https://t.co/qsSGgD9bq7
Robert B Chao, MD doctorRBC ( View Tweet)
Dr. B. Kirkman reviews research and development timeline for IL17A. I've started explaining this trajectory to patients when discussing "newer" drugs to market that have been around since I was in elementary school. #RNL2022 @RheumNow https://t.co/TgaOYmkBO4
Dr. Rachel Tate uptoTate ( View Tweet)
Dr. Kirkman reviews IL12, IL23, and IL17s. #RNL2022 @RheumNow https://t.co/nFHBzrdz2D
Dr. Rachel Tate uptoTate ( View Tweet)