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Declining Menopausal Hormone Therapy in Postmenopausal Women A two decade cross-sectional population study has shown a marked downward trend in menopausal hormone therapy (MHT), with an over 80% reduction, especially in women aged 52 - 65 years. https://t.co/yKPGTOAFvQ https://t.co/72etpOVrSO

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Dr. John Cush RheumNow ( View Tweet)
In utero exposure to upadacitinib review w/ 128 maternal exposures & known outcomes; 80 from RCTs & 48 Postmarketing Pregs. From RCTs - 54-46% live births, 24-38% spont. abortions, 21-15% elective Ab, 1-2% ectopics from RCTs & Postmarketing. No evidence of teratogenicity… https://t.co/s3VJspI59V https://t.co/tV48sKyF8x
Dr. John Cush RheumNow ( View Tweet)
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Which One is the Loneliest Number (9.27.2024)

d Jack Cush, MD

Dr. Jack Cush reviews the regulatory approvals, announcements, guidelines and interesting journal articles from the past week on RheumNow.com. When not to use muscle relaxants, how frequent is loneliness in RA/PsA/SpA, and when to refer patients with Still's disease.

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Lupus nephritis & CKD considerations: - Non-immune factors: obesity, HTN, Na- or protein-diets, NIDDM, pregnancy, mephrotoxic meds, smoking can add to CKD - use inhibitors renin–angiotensin & SGLT2 inhibitor w/ proteinuria & low GFR https://t.co/IgL4hpixOm https://t.co/FvmLhf7tQq

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Dr. John Cush RheumNow ( View Tweet)
Full read review of Neonatal lupus syndrome - caused by pathogenic maternal autoAbs (SSA, SSB) in fetal circulation. Mild Sxs in 25%, severe Sxs are rare; Heart block in up to 2% of neonates born to mothers with positive antibodies. https://t.co/iH4MBRGvg1 https://t.co/kXxIeQC47m

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Dr. John Cush RheumNow ( View Tweet)
So You've Got RA and Want to Get Pregnant? Dr. David Liew reviews abstract POS0436 presented at Eular 2024 in Vienna, Austria. https://t.co/vG9l7kOReq https://t.co/xhumOCisOM

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Dr. John Cush RheumNow ( View Tweet)
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Systemic Sclerosis Insights (9.13.2024)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.

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pregnancy,embryo,fetal

Low Placental Transfer Rates with Risankizumab

d Jack Cush, MD

There are significant concerns about the safety of drug use during pregnancy and lactation, especially newer biologic agents. This is complicated by a lack of research. 

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RF.jpg

Does Rheumatoid Factor Influence Anti-TNF Responses in RA?

d Jack Cush, MD

Smolen and colleagues have published a subanalysis of the EXXELERATE study that showed while certolizumab pegol [CZP] concentrations and efficacy was unaffected by high titers of rheumatoid factor (RF), patients treated with adalimumab had a blunted response in the face of high RF titers.

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Birth Control Use in Lupus Published guidelines on lupus mgmt urge that female patients plan and prepare carefully for pregnancy, and use contraceptives when it's not intended -- but these reco’s are rarely followed, a registry study suggested. https://t.co/81mQbp5Sib https://t.co/NJmwxvtR44

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Dr. John Cush RheumNow ( View Tweet)
BCP,OCP

Birth Control Use in Lupus

d MedPage Today

Published guidelines on lupus management urge that female patients plan and prepare carefully for pregnancy, and use contraceptives when it's not intended -- but these recommendations are only rarely followed, a registry study suggested.

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All in the Family (8.23.2024)

d Jack Cush, MD

Dr. Jack Cush picks highlight reports from the past week on RheumNow.com, with reports on the challenge of lupus nephritis, perplexing skin issues, you don't know JAK (about Tyk) and the value of a good family history.

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Predictors of Pregnancy Outcomes in SLE A review of preconception predictors of pregnancy outcomes in women with SLE highlighted lupus nephritis,chronic hypertension, SLE disease activity and secondary antiphospholipid syndrome as predictors of APO. https://t.co/vA445kSe5t https://t.co/wGhLjCmJ3v

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Dr. John Cush RheumNow ( View Tweet)
Pregnancy, menopause, contraceptives, hormone replacement, aromatase inhibitors may affect lupus outcomes. Review says hormone therapies are contraindicated w/ antiphospholipid syndr, APL Ab positivity, and uncontrolled SLE or flares https://t.co/bZQr8b871n https://t.co/OmXY04GR4p

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Dr. John Cush RheumNow ( View Tweet)
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Higher Cancer Rates (8.16.2024)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com, noting his concerns about diet, cancer, ILD, death and dosing challenges.

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Favorable results from Vasculitis Pregnancy Registry; enrolled 147 women, 149 pregnancies; data on 78 pregs. 36% had active vasculitis during Preg, 14 hospitalized (4 w/ vasculitis. 74% Rx vasculitis meds during preg & 97% live births, 21% preterm https://t.co/rq2Y4ij0OW https://t.co/wmmFPvlOGY

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Dr. John Cush RheumNow ( View Tweet)
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Depends on Where You’re Looking (8.9.2024)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from RheumNow.com this week.

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Calif Cohort of 19340 rheumatic pts, finds Cardiovascular events (CVE) in 1.4% & antiphospholipid syndr in 5.5%. CVE increased risk of adverse pregnancy outcomes (>50%), including Sm for Gestational age (aRRs 1.2-1.5), Premature birth (aRR 1.6) https://t.co/9lxzrOVEks https://t.co/Jcm7tH61cv

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Dr. John Cush RheumNow ( View Tweet)
CDC warns of Listeria outbreak assoc w/ deli meats - in 12 US states (lead by NY, and MN, MO, IL, WI, PA, VA, GA, NJ, DE, MD, MA, NC), 28 cases, 28 hospitalized, 2 deaths. @risk are the pregnant, elderly, immunosuppressed. Cook deli meats >165F https://t.co/SWKMhIBQEi https://t.co/snLjBKn1UJ

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Dr. John Cush RheumNow ( View Tweet)
EULAR 2024 Recommendations on Reproductive Health https://t.co/QuXQlpQv8O https://t.co/nHC7LOLLl8

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Dr. John Cush RheumNow ( View Tweet)

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