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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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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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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/xtPMSZBoWg
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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. Triple positivity, the gut and CRPS, and hope for better outcomes with Vitamin D therapy.
https://t.co/i9OJrYR59T https://t.co/PQ3fAR5teR
Dr. John Cush RheumNow ( View Tweet)
Lupus Unlocked: Journal Club
In this first webinar of RheumNow's Lupus Unlocked campaign, Journal Club discussed two articles:
Efficacy and Safety of Obinutuzumab in Active Lupus Nephritis. Furie R, et al. NEJM. 2025 Feb 7. doi: 10.1056
Efficacy and safety of voclosporin https://t.co/OYv5J8VpRB
Dr. John Cush RheumNow ( View Tweet)
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)
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)
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
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
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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
Dr. John Cush RheumNow ( View Tweet)
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
Dr. John Cush RheumNow ( View Tweet)
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
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)
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/z4zfDq9Wf9
Dr. John Cush RheumNow ( View Tweet)
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/1PoPWPWNec
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)
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/pBJDhXOgut
Dr. John Cush RheumNow ( View Tweet)
