ERA, APPs, & Alpha GAL (3.21.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. Listen in for 2 new case questions - Ask Cush Anything.
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Disease activity during Pregnancy in Rheumatoid arthritis and Spondyloarthritis
A prospective French study of rheumatoid arthritis (RA) or spondyloarthritis (SpA) patients showed that most maintained stable disease activity during pregnancy, but over one-third flared and https://t.co/3k6ZJTybAb
Dr. John Cush @RheumNow( View Tweet )
Systematic review of colchicine and pregnancy in #FMF pts included 25 studies. Miscarriage was not increased w/ colchicine in FMF (RR 0.87). Birth defects were similar to unexposed pts (range 0.6% to 4.0%). Colchicine showed no effects (men/women) on fertility. 1 study reported… https://t.co/axiH9jhEJr https://t.co/oBpew71fZw
Dr. John Cush @RheumNow( View Tweet )
Disease activity during Pregnancy in Rheumatoid arthritis and Spondyloarthritis
A prospective French study of rheumatoid arthritis (RA) or spondyloarthritis (SpA) patients showed that most maintained stable disease activity during pregnancy, but over one-third flared and required major changes in treatment.
The aim of this study was to analyze disease activity and
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Pregnancy is 🔥 inflammatory
Hard to interpret MRI of SI joints in setting of pregnancy
Ideally, don't score MRI during pregnancy or 1 year afterwards, would be affected by the pregnancy
If needed for clinical eval, focus on structural lesions like erosions
#RNL2025 @RheumNow
Eric Dein @ericdeinmd( View Tweet )
Drug Naming Games (2.7.2025)
Dr. Jack Cush reviews the news, regulatory and journal reports from the past week on RheumNow.com.
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QD Clinic - ANA Negative Lupus
Pregnant ANA negative SLE (?) patients with Sjogrens and FM - what to do?
Features Dr. Jack Cush.
QD Clinics - lessons from the clinic, sponsored by RNL2025 in Dallas, TX; Feb 8 & 9, 2025
Register at https://t.co/2dcFVgu8z6… https://t.co/RyCdiadn4H https://t.co/EvWcQ6KIxQ
Links:
Dr. John Cush @RheumNow( View Tweet )
Infertility linked to post-childbrith onset of systemic autoimmune disease
Women who experience infertility but do not use fertility treatments have a higher risk of developing a group of conditions called systemic autoimmune rheumatic diseases (SARD) in the nine years after a… https://t.co/NJf44KJ2Hc https://t.co/W4rhsDHoqB
Dr. John Cush @RheumNow( View Tweet )
Infertility linked to post-childbrith onset of systemic autoimmune disease
EurekAlert!
Women who experience infertility but do not use fertility treatments have a higher risk of developing a group of conditions called systemic autoimmune rheumatic diseases (SARD) in the nine years after a naturally conceived birth compared to women without fertility problems.
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Treat-to-Target Improves Fertility in Women with RA
https://t.co/q9IMI5UHGO https://t.co/uhqaRXeBRX
Dr. John Cush @RheumNow( View Tweet )
ICYMI: Reproductive Issues in axSpA: Fertility and Pregnancy
Axial spondyloarthritis (axSpA) affects young patients with symptom onset occurring in early adulthood. Apart from pain and quality of life, reproductive issues also arise because patients who are diagnosed with the disease are also in their reproductive age. Two interesting abstracts about
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Improving fertility in women with RA
For women with rheumatoid arthritis (RA), the journey to motherhood brings unique challenges, such as longer times to conception and infertility rates twice as high as those without RA. Factors like high disease activity, regular use of… https://t.co/9QXgeB7ftB https://t.co/mVUabSdLNE
Dr. John Cush @RheumNow( View Tweet )
Treat-to-Target Improves Fertility in Women with RA
Dr. Richard Conway discusses abstract 1647, presented at #ACR24
https://t.co/vC0CA0lN4M https://t.co/Dfo7iBYwcU
Dr. John Cush @RheumNow( View Tweet )
Improving fertility in women with RA
For many women, the journey to motherhood brings a sense of anticipation and joy. However, for those with rheumatoid arthritis, this journey presents unique challenges. At ACR Convergence 2024, researchers discussed how advancements in reproductive medicine and RA management are paving the way
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Is Pregnancy Truly the Solution for RA?
Pregnancy is perhaps the oldest treatment in rheumatoid arthritis (RA) and has been associated with a natural improvement in disease control in 50-75% of patients. Others, however, are not as successful with unchanged disease activity or… https://t.co/MesVIUl0fC https://t.co/760i5znmeu
Dr. John Cush @RheumNow( View Tweet )
Reproductive Issues in axSpA: Fertility and Pregnancy
axSpA affects young patients with symptom onset occurring in early adulthood. Apart from pain and quality of life, reproductive issues also arise because patients who are diagnosed with the disease are also in their… https://t.co/8tLFOvFqdO https://t.co/E3AOOCHTgu
Dr. John Cush @RheumNow( View Tweet )
If a mother has had TNFi during pregnancy, can a baby have a live oral rotavirus vaccine (usually at 2mo)?
This claims data suggests no increase in diarrhoea
Adds to similarly reassuring 🇨🇦prospective cohort data https://t.co/2Tz9zRhPjz
Vaccinate away!
#ACR24 ABST0806 @RheumNow https://t.co/66OIAR8W6l
Links:
David Liew @drdavidliew( View Tweet )
Nice data from the OTIS Autoimmune Disease in Pregnancy Project re: certolizumab-exposed pregnancies:
- spontaneous loss rate comparable to non-disease controls
- no stillbirths
- preterm similar to disease controls
Plenty positive for CZP in pregnancy!
#ACR24 ABST0805 @RheumNow https://t.co/XCRYsioxC0
David Liew @drdavidliew( View Tweet )
A key practice changing study (I hope) from #ACR24 has been the preCARA study. Fertility increases with aggressive disease control. My video on this study is up now on @RheumNow https://t.co/Pf3rdTHbOJ
Richard Conway @RichardPAConway( View Tweet )
In this systematic review & metaanalyis by Dr. RFarhat et al, tacrolimus whole blood levels decrease in the 1st & 2nd trimesters then increase back to pre-pregnancy levels postpartum.
Needs further studies to guide dose adjustment.
@RheumNow #ACR24 abs1535 https://t.co/5MovzPJoFc
sheila @RHEUMarampa( View Tweet )
Study on pregnancy outcomes in SLE with thrombocytopenia:
Higher disease activity, pregnancy loss, and stillbirth rates
Identified risk factors: Anti-β2GP-I positivity and higher SLEDAI score #ACR24 abst#1487 @RheumNow
Bella Mehta @bella_mehta( View Tweet )
Quaack etlal. PreCARA study (vs PARA, historical control). T2T in RA improves fertility - time to pregnancy 84 days vs 196 days. T2T strategy also led to less NSAIDs and prednisolone. @RheumNow #ACR24 Abstr#1647 #ACRbest https://t.co/vYCCUqpCLo https://t.co/PUHJOxgGbL
Links:
Richard Conway @RichardPAConway( View Tweet )
Plenary II: pregnancy in RA
When a treat to target approach is used to achieve remission, pregnancy rates nearly similar to general population!
Time to pregnancy less than half that of non-T2T comparators
@RheumNow #ACR24 https://t.co/B9F9M8t9Kt
Links:
Brian Jaros, MD @Dr_Brian_MD( View Tweet )
Improved fertility in women with RA when treated with a Treat-to-Target (T2T) approach aimed at remission.
Key findings:
- Shorter time to pregnancy (TTP) in PreCARA cohort (84 days) vs. PARA cohort (196 days).
- Increased TNF-inhibitor use and lower NSAID/prednisone use in the… https://t.co/YyD2lpXVRC https://t.co/LH5LMOH8al
Links:
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Managing DMARDs in pregnancy. Curbside consults by Lisa Sammaritano @RheumNow #ACR24 https://t.co/FQrLNz4yCz
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
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