RheumNow Podcast – Lupus Delights (9.18.20)
Sep 18, 2020
Dr Jack Cush reviews the news and journal reports from the past week on RheumNow.com:
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COVID-19 Risks in Pregnant Women
Sep 17, 2020
There has been little science or evidence regarding the effects of COVID-19 infection on pregnancy and vice versa; and now the recent MMWR addresses the subject with two new reports
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Belimumab Effective in Lupus Nephritis
Sep 16, 2020
Dr. Rich Furie has lead a group of investIgators in reporting the significant efficacy of intravenous belimumab when added to standard of care induction therapy in patients with active lupus nephritis. This phase 3, 2-year study included 448 systemic lupus erythematosus patients with biopsy
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Taiwan National Health population study of 650 SLE and non-SLE controls undergoing hip replacement. SLE did not incr risk of early prosthetic infx, but did incr risk of late superficial wound infection (11.4% vs.
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Sep 16, 2020
Mediterranean Diet May Reduce Risk of RA
Sep 15, 2020
Arthritis and Rheumatology reports that a Mediterranean diet (MD) is capable of reducing the high risk of RA among women who have smoked tobacco. The results stem from the E3N Study, a French prospective cohort study that collects dietary data on 98,995 women since 1990. An MD score was derived
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Updated List of Drugs Inducing Lupus
Sep 14, 2020
Drugs inducing lupus may account for nearly 30% of all subacute cutaneous lupus erythematosus (CLE) and up to 15% of systemic lupus erythematosus (SLE) cases. Moreover there are over 100 drugs capable of inducing drug-induced lupus erythematosus. A population based report in JAMA
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RheumNow Podcast - ACR Reproductive Health Slides (9-11-20)
Dr Jack Cush reviews the 2020 ACR Reproductive Health Guidelines
This past week we presented an overview to the new 2020 ACR
ACR 2020 Reproductive Guidelines - Contraception & Counseling
https://t.co
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Sep 13, 2020
Candian study of 376 pregnancies (284 F) with #SLE and drug use: only 24.2% on antimalarials, 8.2% azathioprine, 19.7% steroids & 4.8% on NSAIDs during pregnancy. 1st trimester discontinuations seen in 16.7% of HCQ & 29.2% AZA https://t.co/a1SMwZuSlm
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Sep 13, 2020
New data on tocilizumab in pregnancy, upshot is: "Tocilizumab concentrations in cord blood and infant serum were 80–90% of those in maternal serum" https://t.co/SEmyTnL7dy
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Sep 12, 2020
Immunomonitoring with microarrays from the SLE PROMISE pregnancy study shows that adverse outcomes (preeclampsia) can be identified by quantifying plasma cell, interferon and neutrophil RNA levels during the pregnancy https://t.co/oLOwkiGhQ2.
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Sep 11, 2020
Systematic review of Paternal DMARD exposure prior to pregnancy shows no firm evidence of harm with TNFi, ABA, RTX, azathioprine, cyclosporine, HCQ, leflunomide, MTX or mycophenolate mofetil.
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Sep 11, 2020
ACR 2020 Reproductive Guidelines - Lactation Guidance
Sep 10, 2020
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.
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ACR 2020 Reproductive Guidelines - Medication Use with Pregnancy
Sep 09, 2020
The American College of Rheumatology (ACR) has published guidelines to manage reproductive health issues in rheumatic disease (RMD) patients before, during and after pregnancy. In this second exerpt from their guidelines articles we present recommendations (and good clinical practice
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Free full read review "Postnatal Care of Woman with Rheumatic Dz". 46% of RA pts will flare postpartum; breast feeding is ok w/ most biologics; Hold Live vaccines if Pt is on a biologic during pregnancy; VTE prophylaxis essential for 10 d–6 wks postpartum.
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Sep 09, 2020
Case series compared 247 pregnancies in IgA Vasculitis patients vs 556 control pregnancies showing IgA Vasculitis had no effect on fertility and did not induce flares. But IgAV had more spont. abortions, gestational HTN, preterm delivery.
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Sep 09, 2020
ACR 2020 Reproductive Guidelines - Contraception & Counseling
Sep 08, 2020
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,
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Analysis of Natl Inpatient Sample database (1998-2014) compared outcomes in 87605 SLE pregnancies vs matched cohort: found SLE had more C-section, IU fetal death, Pre-eclampsia, VTE, CKD, HTN, longer stays Presented by Dr.
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Sep 08, 2020
#ACR18 @rheumnow abs 2419. In a busy clinic, ask 'one key question' as a way to opening discussion on pregnancy planning in SLE. With an EPR it can even come up as a prompt on your screen. https://t.co/Y1hp7ILB2N
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Sep 08, 2020
ICYMI: HCQ May Help Prevent Fetal Heart Block
Sep 08, 2020
Hydroxychloroquine (HCQ) helped reduce recurrent maternal autoantibody-mediated congenital heart block (CHB) in fetuses, an open-label study suggested.
Anti-SSA/Ro-positive mothers who had had a previous pregnancy complicated by CHB who took HCQ 400 mg daily, starting before
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RheumNow Podcast – To Celiac Test or Not? (9.4.20)
Sep 04, 2020
Dr Jack Cush reviews the news, journal articles and takes a few Back Talk questions this week:
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Insights into Antinuclear Antibodies in Systemic Lupus Erythematosus
Sep 03, 2020
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.
ANAs are directed at DNA or
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Treatment Options for Extraintestinal IBD
Sep 03, 2020
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
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Study of 211 SSc pts (70% with limited SSc) & during 120 (50-216) mos F/U, 105 (50%) had 1 or more skin ulcer (SU); 66% recurrent/persistent SUs.
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Sep 02, 2020
Comparative retrospective study of 251 ANCA+ pts with AAV (MPA or GPA) & severe renal Dz induction Rx with CYC or RTX, +/- PLEX. Remission equally achieved by CTX or RTX; addition of PLEX did not change outcomes.
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Sep 01, 2020
COVID and the Multisystem Inflammatory Syndrome in Children
Aug 31, 2020
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
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