#ACR21 #ACR2021 Rheumatology Reproductive Health 👉🏻 Biologics and breast milk 👉🏻 Good vaccine response with TNFi (like with covid vaccines ) 👉🏻 ustekimumab seems safe in pregnancy 👉🏻 Tofacitinib/ small molecules may cross placenta/ be in breast milk ➡️ contraindicated in preg/BF https://t.co/qk3sLR4QHz

COVaRiPad study - Immunosuppression affects COVID-19 vax Ab levels. 247 pts, 90% seroconverted but @ reduced (3.4 fold) titers. Lowest w/ MMF (21x) and B cell Rx vs MTX/AZA (3-4x). Pts on B cell therapy should wait 6 mos to recv vax #ACR21 Abstr# 0457 https://t.co/1gkCsJSDBk

RZB tx resulted in statistically greater improvements in signs/ symptoms of PsA vs PBO and was well tolerated w/ no new safety signals. Plenary Abs 0453 #ACR21 #RheumNow #ACRbest @RheumNow https://t.co/c9RJdWlmpO https://t.co/MDbdAhdnIy

• Efficacy and Safety of Risankizumab for Active Psoriatic Arthritis: 24-Week Int…

Retrospective study of FAERS database: 186 irAE w/rheum manifestation 👉4.7% of all AEs 👉Arthritis, myositis, Sjogren, sarcoidosis were frequent 👉myositis assc w/ durvalumab, avelumab, atezolimumab and cemiplimab #ACR21 Abstr#0438 #Plenary @rheumnow https://t.co/t8UQWQicFc https://t.co/FGo6WCDQTp

• Rheumatological Immune-Related Adverse Events of Immune Checkpoint Inhibitors B…

Retrospective study of cancer pts Rx w/ ICI and autoimmune Ab (ANA, RF, CCP, SSA/SSB, ANCA) 👉152 pts 👉59% had irAE 👉preICI Ab+⬆️odds of irAE (OR 17.5 95% CI 1.76-174, p=0.015) 👉strong assc b/t +RF and +CCP for ICD-arthritis #ACR21 Abst#0440 @Rheumnow https://t.co/kUv5ddSAnY

• Association Between Rheumatic Autoantibody Positivity and Immune-related Advers…

Large case-control study (n=8028) to identify baseline predictors of rheum irAEs after immune checkpoint inhibitor initiation for cancer. Type of cancer (melanoma, GU), combination ICI, pre-existing autoimmune disease, and recent GC use each had higher odds of rheum irAE #ACR21 https://t.co/rHI6VQ37QB

@jhrheumatology Dr. Petri at #ACR21 Great Debate. Safety issues with Voclosporin: 1) Nephrotoxicity 2) Infection 3) CV Risk Factors 4) Malignancy 5) Neurologic toxicity 6) Osteoporosis 7) Drug interactions 8) Deaths 9) Pregnancy contraindication @RheumNow https://t.co/wjluivmKNt

Experts (Drs. M Clowse, Sammaratino) limit mAb TNFi 1 month b/f delivery or extend dosing. But, they do dose again for flares. Risk for infection is low based on the PIANO registry. Postpartum, they restart the meds w/in 1 week (vag delivery), 2 weeks C/S @rheumnow #pregnancy