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Keys to Mastery (5.2.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, articles and drug approvals from the past week on RheumNow.com. This podcast marks the beginning of our Lupus Campaign called "Lupus Unlocked: Keys to Mastery". This month's campaign on Lupus is sponsored by Aurinia.

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Contraception in SLE

Lisa Sammaritano MD

Pregnancy in SLE gets a lot of press in the rheumatology literature, and deservedly so, since pregnancy risks can be markedly increased. It was not that many years ago that women with SLE were counseled to avoid pregnancy.

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EULAR Guidelines on Reproductive Health

MedPage Today

Rheumatology patients considering or actually having babies can safely take most of the medications currently used to treat their conditions, according to an updated guideline from the European Alliance of Associations for Rheumatology (EULAR).

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Pregnancy-Related Deaths in the US

Jack Cush, MD

A CDC cross-sectional national study showed an increase in pregnancy-related deaths in the US from 2018 to 2022, with highest rates among American Indian, Alaska Native women, and non-Hispanic Black women. 

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Norwegian RevNatus Pregnancy study on 417 births in 350 women w/ axSpA: 86% (347) were breastfeeding @6wks, 70% @6mos, & 38% @12 mos. Non-breastfeeders more likely to have C-section (41 vs 20%), higher ASDAS-CRP (2.6 vs 2.2), CRP (5.3 vs 3.3), & VAS pain (41 vs 32) https://t.co/DI6owL5dof
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Norwegian RevNatus Pregnancy study on 417 births in 350 women w/ axSpA: 86% (347) were breastfeeding @6wks, 70% @6mos, & 38% @12 mos. Non-breastfeeders more likely to have C-section (41 vs 20%), higher ASDAS-CRP (2.6 vs 2.2), CRP (5.3 vs 3.3), & VAS pain (41 vs 32) https://t.co/GhLtLqT0iS
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Vitamin D for Prevention of Disease JAMA has published a clinical guideline on the use of vitamin D to prevent disease in children and adults. Guideline committee experts, included adult and pediatric endocrinology, internal medicine, obstetrics/gynecology, nutrition, and https://t.co/zi3CpE0DVN
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A review of 18 guideline recommendations on DMARDs in pregnancy & reproductive health. There were recs. DMARDs & pre-conception (56%), lactation (67%), male fertility (33%), & use of csDMARDs (72%), bDMARDs(72%), tsDMARDs (28%); less recs for b/tsDMARD use https://t.co/tKGCXrbOuc
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Should Lupus Nephritis Receive PJP Prophylaxis? A current review article suggests that the need for Pneumocystis jirovecii pneumonia (PJP) prophylaxis in patients with systemic lupus erythematosus (SLE) and lupus nephritis will need to be individualized based on therapies and https://t.co/QGHxk3O8q4
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Systematic review of >90 studies on Pregnancy and RA risk indicates that parity, gravidity, infertility, pregnancy loss do not adversely affect RA development. But low birthweight was assoc w/ RA Dx/severity, and pre-eclampsia incr risk of subsequent RA Dx. https://t.co/nw8FfWyM8A
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RheumNow
Systematic review of >90 studies on Pregnancy and RA risk indicates that parity, gravidity, infertility, pregnancy loss do not adversely affect RA development. But low birthweight was assoc w/ RA Dx/severity, and pre-eclampsia incr risk of subsequent RA Dx. https://t.co/jVa4tmSqvj
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RheumNow
Disease activity during Pregnancy in Rheumatoid arthritis and Spondyloarthritis A prospective French study of rheumatoid arthritis (RA) or spondyloarthritis (SpA) patients showed that most maintained stable disease activity during pregnancy, but over one-third flared and https://t.co/MaWx6AZ0JF
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RheumNow
Disease activity during Pregnancy in Rheumatoid arthritis and Spondyloarthritis A prospective French study of rheumatoid arthritis (RA) or spondyloarthritis (SpA) patients showed that most maintained stable disease activity during pregnancy, but over one-third flared and https://t.co/3k6ZJTybAb
Dr. John Cush Tweet
RheumNow
Systematic review of colchicine and pregnancy in #FMF pts included 25 studies. Miscarriage was not increased w/ colchicine in FMF (RR 0.87). Birth defects were similar to unexposed pts (range 0.6% to 4.0%). Colchicine showed no effects (men/women) on fertility. 1 study reported… https://t.co/axiH9jhEJr https://t.co/oBpew71fZw
Eric Dein Tweet
ericdeinmd
Pregnancy is 🔥 inflammatory Hard to interpret MRI of SI joints in setting of pregnancy Ideally, don't score MRI during pregnancy or 1 year afterwards, would be affected by the pregnancy If needed for clinical eval, focus on structural lesions like erosions #RNL2025 @RheumNow
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