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ACR 2020 Reproductive Guidelines - Lactation Guidance

In this third excerpt from the ACR guidelines on managing reproductive health issues in rheumatic disease patients, we present recommendations regarding the use of glucocorticoids and guidance on lactation and medication use post-partum.

ICYMI - The Pregnancy & Lactation Labeling Rule Explained

A recent article from Healio.com reviewed the FDA’s Pregnancy and Lactation Labeling Rule (PLLR) that became effective June 30th.

ACR 2020 Reproductive Guidelines - Medication Use with Pregnancy

The American College of Rheumatology (ACR) has published guidelines to manage reproductive health issues in rheumatic disease (RMD) patients before, during and after pregnancy.

ICYMI - 11 Pearls for Pregnancy Management in Rheumatoid Arthritis

Rheumatoid arthritis affects women in their child-bearing years and many will face the issue of pregnancy and RA management at some point. Here are11 considerations for those managing RA patients who wish to become pregnant.

ACR 2020 Reproductive Guidelines - Contraception & Counseling

The American College of Rheumatology established a guidelines committee that consisted of both patients, rheumatologists and maternal-fetal health experts. After a a systematic review of the medical literature regarding contraception, assisted reproductive technology, fertility preservation, hormone replacement therapy pregnancy, lactation, and medication use in rheumatic disease patients, they published 12 good practice statements and 131 recommendations for reproductive health care in RMD patients.

ICYMI: HCQ May Help Prevent Fetal Heart Block

Hydroxychloroquine (HCQ) helped reduce recurrent maternal autoantibody-mediated congenital heart block (CHB) in fetuses, an open-label study suggested.

RheumNow Podcast – To Celiac Test or Not? (9.4.20)

Dr Jack Cush reviews the news, journal articles and takes a few Back Talk questions this week:

Insights into Antinuclear Antibodies in Systemic Lupus Erythematosus

Pisetsky and Lipsky have reviewed the evolving literature on the utility of antinuclear antibodies (ANA). ANAs generated as part of an autoimmune disorder may form immune complexes that mediate pathogenesis by tissue deposition or cytokine induction.

Treatment Options for Extraintestinal IBD

Extraintestinal manifestations (EIMs) frequently accompany inflammatory bowel disease, often augmenting morbidity and mortality are associated with disease activity and may increase the need for surgery or treatment escalation.  A recent review in GUT details the treatment options for patients with EIM.

Older Lupus Patients Can Stop HCQ Without Increasing Flare Risk

Since patients with SLE have longer life expectancies in the modern era, they may be at elevated risk for HCQ adverse events, including maculopathy and cardiomyopathy. Therefore, Peter M. Izmirly, MD, of New York University School of Medicine in New York City, and colleagues assessed whether older SLE patients could safely discontinue HCQ.

Early Cardiovascular Benefits to DMARD Treatment in Rheumatoid Arthritis

ARD has published a report showing that patients with early rheumatoid arthritis have cardiovascular disease that is modifiable with conventional and aggressive therapy and that it did not matter if first line DMARD therapy was with a tumour necrosis factor-inhibitor or methotrexate.

Steroid Bursts and Adverse Events

Annals of Internal Medicine has published a population based study showing that the use of (short term) corticosteroid bursts were associated with GI bleeding, sepsis, and heart failure, often occurring within the first month of steroid therapy. 

COVID and the Multisystem Inflammatory Syndrome in Children

Lancet Infectious Disease has reviewed the epidemiology, causes, clinical features, and current treatment for the multisystem inflammatory syndrome in children (MIS-C) and adolescents associated with COVID-19, noting severe organ damage can occur pediatric COVID-19 patients who are severely ill.&

CDC: COVID Seroprevalence in Health Care Workers

MMWR

CDC reports that gmong 3,248 healthcare personnel (HCP) observed, 6% had antibody evidence of previous SARS-CoV-2 infection; 29% of personnel with SARS-CoV-2 antibodies were asymptomatic in the preceding months, and 69% had not previously received a diagnosis of SARS-CoV-2 infection.

Sleep, Fatigue and Depression in Psoriatic Arthritis

Comorbidities are highly prevalent in psoriatic disease. A recent study in Arthritis Research & Therapy suggests a high prevalence of sleep disturbances, fatigue, and anxiety/depression in psoriatic arthritis (PsA) that is unrelated to skin disease musculoskeletal (MSK) man

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