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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. 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
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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:
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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
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Metanalysis of ANCA-associated vasculitis with interstitial lung disease (8 studies, 654 pts shows the following significan mortality risk factors: age (HR 1.06), ever smoker (HR 1.61), UIP pattern (HR 2.07), acute exacerbation (HR 2.73) & microscopic polyangiitis (HR 4.03). https://t.co/Rf6c2gidpK
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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
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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
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International Myositis Assessment and Clinical Studies Group (IMACS) reached a consensus on ‘anti-synthetase syndrome’ as the preferred nomenclature and "ASyS" as the preferred abbreviation for the ‘anti-synthetase syndrome. https://t.co/TuTzVVZzZO https://t.co/EJkxX6aP56
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Arterial or venous thrombotic events (AVTEs) are common w/ new forms of monogenic vasculitis (DADA2 & VEXAS), resulting from pathogenetic mechanisms of endothelial dysfunction, immune complex deposition and pro-inflammatory cytokines. Reviewed here. https://t.co/Nw9wNYssg3 https://t.co/5V0yrctaFI
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Study of 42 pts w/ long standing RA-LD undergoing Lung Transplant (LTx) betw 2004 -2020. Median survival was 5.3 yrs (1-yr survival 88%) - same survival as LTx in other CTD & non-CTD ILD LTx. Mortality was 43%, higher w/ UIP. RA/CTD is not a contraindication to LTx. https://t.co/C0dpThYcMT
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D-Lay Trial: High-Dose Vitamin D Retards Multiple Sclerosis
A randomized clinical trial with oral high-dose cholecalciferol ( vitamin D3) was shown to prevent or delay the onset of clinically isolated syndrome (CIS), typical for multiple sclerosis (MS). https://t.co/ZcO5wt33Z0
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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
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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
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Single-centre retrospective study, 27 children with refractory juvenile dermatomyositis (jDM) Rx with baricitinib (F/U of 25 mos)-- 77% (21/27) improved skin rashes (62% complete resolution) & Dz activity improved (6 vs 0.8, p<0.01) 70% (19/27) achieved inactive disease https://t.co/rRlhoY9O4q
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RA nodules respond to JAKi. Small case series of 7 established/refractory moderate-to-severe#RA pts w/ rheumatoid nodules who were treated w/ JAKi (tofacitinib, upadacitinib)-- 5/7 had complete resolution & 1 reduced nodules size (w/in 3-12 mos) on JAKi therapy. https://t.co/oQWHMBVQEi
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Pitfalls in sacroiliitis imaging: Bone marrow edema may also be seen in young-middle-aged postpartum women, & athletes & kids (ongoing bone growth) & w/ advancing age (DJD) https://t.co/bwS047wlmI https://t.co/pqI3xTYtCz
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single-centre study of 469 consecutive RA pts - 15 had VTE (3%). Strongest risk factor of VTE was the history of previous VTE (OR 44.7), recent hospitalisation (OR 6.82), diabetes (OR 11.23), and JAKi (OR 5.54) (Other studies show inflammation incr VTE risk) https://t.co/JfaBtfvujU
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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)
