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OP0129 Eudravigilance eval pregnancies exposed to non-TNF biologics compared certolizumab. Possible signal w/#vendolizumab: 3 cases of corpus callosum agenesis (2 Crohn’s, 1 UC, 2 assc w/ other CNS malformations). Belim did not show consistent pattern #EULAR2022 @rheumnow https://t.co/BNKaxu6G0c
TheDaoIndex KDAO2011 ( View Tweet)
No need to switch TNFi during pregnancy. Study compared high placental vs. low placental transfer TNFi- no sig difference for SIE in childhood. Dr. L Flatman comparing different TNFi in pregnancy: 26,000 offsprings #EULAR2022 @rheumnow OP0130 https://t.co/IF5hepQoHc
TheDaoIndex KDAO2011 ( View Tweet)
Pregnancy outcomes in SpA
Increased risk of
❗️gestational diabetes aRR 1.88
❗️Cesarean delivery aRR 1.54 & 1.23
❗️preterm birth aRR 1.52
❗️trend for increased infection
in 1st year of life in newborns aRR 1.23.
#EULAR2022 @RheumNow OP0126 https://t.co/jMryB5UXQr
Aurelie Najm AurelieRheumo ( View Tweet)
🚨 Study on MTX and male fertility
Analysis of semen parameters in
🙋🏼♂️HC
🙋🏼♂️RA, PsA and PsO MTX naive
🙋🏼♂️Post MTX
Reassuring data as NO significant effect of MTX was observed on several semen parameters.
#EULAR2022 @RheumNow
OP0131 https://t.co/Fq32lzAMAx
Aurelie Najm AurelieRheumo ( View Tweet)
#Belimumab safety in pregnancy
EudraVigilance database retrospect study 47 preg: BEL stopped 1st trimester (group A) vs. cont'd (group B)
- no diff in fetal death
- more preterm birth/low birth weight, congenital malform'n in group A (not stat sig) #EULAR2022 @rheumnow POS0705 https://t.co/sLQ3MHNcWa
TheDaoIndex KDAO2011 ( View Tweet)
Hamroun S et al for the GR2 Cohort showed that age HR 1.22 and use of NSAIDs HR 3.01 in the pre-conception period was associated with a longer time to conception in women with SpA. Research is needed on continuous NSAID use in the preconception period #EULAR2022 @RheumNow OP0153 https://t.co/hl6jUlK5PN
Dr. Antoni Chan synovialjoints ( View Tweet)
GR2 cohort prospective study of pregnancies in 126 pts w/ SpA over 15 years
-Rx exposure 23% steroids, 11% NSAIDS, 55% biologics
- 116 live births, 7 miscarriages, 3 stillbirths
- 36.5% had unfavorable pregnancy outcomes
- 19% SGA
- 4.8% preterm birth
#EULAR2022 @rheumnow POS1000
TheDaoIndex KDAO2011 ( View Tweet)
#OP0002 #EULAR2022 What immune tests to monitor during pregnancy in #lupus? A meta-analysis found:
💠32% had a flare (new IS or Pred>9mg/d)
💠⬇️C3 and/or C4 in 1st Trimester predicted LN or SLE flare
Worth checking C3/C4 in each trimester @RheumNow https://t.co/fPEXwReK7u https://t.co/BX6fzKzfvC
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Retrospective pregnancy outcome study in 154 Rheumatic pts. Systemic sclerosis pts had higher risk of adverse preg outcomes (vs HC - 60.6% vs 10.0%; OR = 14; SSc had increase in 1st trimester miscarriage, preeclampsia, SGA & Preterm https://t.co/hfd6SsCRmr
Conclusions
Links:
Dr. John Cush RheumNow ( View Tweet)
Watch: Pregnancy Paradox: How Stopping Drugs Leads to Greater Harm
Uma Mahadevan, MD talks about the pregnancy paradox and how stopping medications in pregnancy to protect the fetus can actually lead to greater harm.
https://t.co/HYO5BdjwzZ https://t.co/IGeZ3O8Dno
Links:
Dr. John Cush RheumNow ( View Tweet)
Methotrexate Monitoring (5.13.2022)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Bad news for digitial ulcers in Systemic sclerosis, Readmissions in Lupus and Thrombocytopenia in APL patients.
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Three (3) Worst Drugs to use in #Lupus patients who want to be pregnant (MTX, MMF, CTX) #UTSWSLE2022 https://t.co/YBeLTuRLO1
Dr. John Cush RheumNow ( View Tweet)
Algorithmic approach to SLE and assessing/treating early pregnancy. #UTSWSLE2022 https://t.co/692el4R9sZ
Dr. John Cush RheumNow ( View Tweet)
Adverse pregnancy outcomes and Risks in #SLE. (Dr. Eliza Chakravarty - OMRF) #UTSWSLE2022 https://t.co/HqscJD2m96
Dr. John Cush RheumNow ( View Tweet)
Nearly 40% of all #SLE pregnancies are unplanned - hence, contraception (unused in 73%) and education are paramount in management of women w/ SLE. (Dr. Lisa Sammaritano- HSS) #UTSWSLE2022 https://t.co/ooryrW9GGn
Dr. John Cush RheumNow ( View Tweet)
Danish case-control registry of 491,274 women shows Psoriasis assoc w/ increased risk of ectopic pregnancy (EP) (OR 1.34), highest in women w/ moderate-to-severe psoriasis (OR 2.77). EP risk was 2.5x higher for women w/ mod--severe PSO https://t.co/vUtNEMDOhr
Links:
Dr. John Cush RheumNow ( View Tweet)
Canadian study of 6012 Pregnancies w/ +COVID-19 PCR test shows Preg pts increased risk of hospitalization (RR 2.65) & ICU adm (RR 5.46) vs gen population and higher risk of preterm birth vs preg women without COVID (RR 1.63) https://t.co/6UAaa0Jf8j https://t.co/aLQbxZArmq
Links:
Dr. John Cush RheumNow ( View Tweet)
$30 Billion and Counting (4.29.2022)
Dr. Jack Cush reviews the news and journal reports and takes viewer questions this week.
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Pregnancy outcomes in systemic sclerosis (SSc) studied in 154 pregnancies from SSc, SLE, APS, & controls (2008 to 2019). Adverse Preg Outcomes APO significantly higher in SSc vs HC (61% vs 10%) w/ more miscarriages, preeclampsia, SGA & preterm births https://t.co/P3uksmJy6V https://t.co/nTtgwjdGgL
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Dr. John Cush RheumNow ( View Tweet)
UK drug safety warning, observational data 2700 pregnancies, 1st trimester pregabalin (Lyrica) use was assoc w/ higher rate of congenital malformations (5.9 vs 4.1%). US PI label says Lyrica use in Pregnancy "May cause fetal harm". https://t.co/GdIitpe8KW
Links:
Dr. John Cush RheumNow ( View Tweet)