Treating During Pregnancy (11.14.2025) Save

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

1. Western Australia study of 1854 SLE pts (median 40 yrs old). Interstitial lung disease was seen in in 3.8% of SLE, 26 fold more than controls. Risk factors for ILD included older age, smoking and serositis. SLE-ILD pts had higher mortality rates (MR 52.0, CI 37.0–71.1).
2. Topline results of ALLEGORY study (Genentech) - 300 pt. phase 3 DBRPCT obinuntuzumab vs PBO in active SLE w/ SRI-4 primary outcome at wk 52. The anti-CD20, B-cell depleter, Rx met all efficacy endpoints primary and all key secondary endpoints. Gazyva was FDA approved last wk https://t.co/Wd6EFEjvGP
3. Now published: The 2025 ACR Guideline for the Treatment of Systemic Lupus Erythematosus https://t.co/56eOK86lmn
4. Genetic Risks and Severe Cutaneous Reactions to Allopurinol A matched cohort study shows that HLA-B*58:01 and HLA-A*34:02 are strongly associated with allopurinol-induced severe cutaneous adverse reactions (SCARs), these alleles were absent in more than one-third of those https://t.co/NLpHVhr9Ww  16 pts w/ SJS/TENS allop vs 160 w/o
5. Biologic use in 5008 IBD pts finds higher serious infxn (SIE) rates (vs, RA or PsO). In UC the SIE rate was 5.5/100PY w/ vedolizumab & 7/100PY w/ other biologics. In Crohns the SIE rate was 7.9/100PY w/ vedolizumab vs 6.5/100PY w/ other biologics (adj HR 1.15; 0.95–1.40) (P .16) https://t.co/R7YC220NnO
6. Systematic review of 10 studies showed TNFi exposure in utero not assoc w/ incr risk of infant severe infxn (4 RCTs); same for breast milk exposure (2 RCTs). Infant vaccination outcomes unaffected by TNFi use, but rec delaying BCG vaccination if TNFi exposed https://t.co/02Nn6TuzR3
7. Marketscan claims study of 62,813 IMID women w/ 70,529 pregnancies & 69,412 births, 4,485 (7.1%) were exposed to at least one TNFi during pregnancy & 3,559 postpartum. TNFi use NOT assoc w/ SIE risk during Preg (HR 1.39; 0.95-2.05) or postpartum (HR 1.22; https://t.co/NsxOLpT0ds
8. Swedish Birth Registry study of adverse preg outcomes (APOs) after SSc Dx [n=941] or w/in 3 yrs [39] or > 3yrs pre-Dx [839]. SSc women have incr APOs post-Dx, including preeclampsia (RR 3.8), preterm (3.3), C-section (2.5); but also incr APO risk w/in 3 yrs of Dx
9. In 2024, 77 pts referred to Rheum for possible PMR were ultimately Dx w/ B19 viral infx. 96% had arthralgia & 7% had PMR-like features (5/5 w/ BL shoulder/neck. prolonged AM stiff, fever & Hi CRP/ESR - none had hip pain. 4/5 were male, w/ mean age of 55 yrs. None were RF/CCP+ https://t.co/AiK2K9whBH
10. There is a growing burden of #OA among middle-aged (40-59 yrs) adults, rising by 123.7%, from 11.8 million in 1990 to 26.4 million in 2021. 56.5% of incident cases & 38% of prevalent cases occur in middle-aged group (70% higher than the elderly (>60 years) population). Highest in hi-income. https://t.co/JVpZ96qe0E
11. S.Korean study of 481 pts w/ myositis (IIM) - 12.9% (n = 62) had myositis-assoc. cancer. CA risk factors= older age, male, current smoking, dermatomyositis, TIF1γ; but lower risk w/ anti-synthetase syndr, overlap myositis, arthritis, & ILD. SCRIM score had AUROC = 0.852 https://t.co/MdU1fRWWgS
12. Hospital Mortality in Dermatomyositis  https://rheumnow.com/news/hospital-mortality-dermatomyositis
13. IL-1 Inhibition in CPPDhttps://rheumnow.com/news/il-1-inhibition-cppd
14. DAHLIAS study - Nipocalimab in Sjögren's Disease
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