NHANES, Numbers, & Risk (7.18.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com along with interesting case questions from "Ask Cush Anything".
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French Teratology Service study of 57 pregnant women exposed to anti-IL-1 (47% for Stills Dz) found no evidence of adverse pregnancy outcomes with IL-1 inhibition (43 anakinra, 5 canakinumab) 85% livebirths, 11% early miscarriages. Major congenital malformations 3% https://t.co/iyLvaNKA2o
Dr. John Cush @RheumNow( View Tweet )
Systemic sclerosis have more adverse pregnancy outcomes. Swedish Medical Birth Register study pre- & post SSc Dx (94 vs 978) finds incr risk post SSc for preeclampsia (RR 3.8), preterm birth (3.3), & caesarean (2.5). No incr of maternal or neonatal death, nor stillbirth https://t.co/9PWREN62r0
Dr. John Cush @RheumNow( View Tweet )
Swedish Medical Birth Register study of pregnancy in systemic sclerosis (SSc) shows increased risk of preeclampsia (RR 3.8; 1.8-7.8), preterm birth (3.3; 1.8-6.1), & caesareans (2.5; 1.8-3.5) esp w/ 1st pregnancy -- but not incr. maternal or neonatal death, nor stillbirth https://t.co/SNSK5947zO
Dr. John Cush @RheumNow( View Tweet )
Pregnancy in SLE: Risks Extend Beyond Clinical Concerns
Pregnancy in patients with systemic lupus erythematosus (SLE) continues to carry significantly elevated risks, with maternal mortality rates nearly five times higher than in the general population.
https://t.co/3G7Eftt0Kg https://t.co/X3SUl6FTHO
Dr. John Cush @RheumNow( View Tweet )
Add-on certolizumab in pregnant women with APS
Women with antiphospholipid syndrome and lupus anti-coagulant are at high risk of developing adverse pregnancy outcomes (APO). Usual care includes low molecular weight heparin (LMWH) and low dose aspirin (LDA). https://t.co/qnnkFlhtiS
Dr. John Cush @RheumNow( View Tweet )
Pregnancy in SLE: Risks Extend Beyond Clinical Concerns
While clinical comorbidities such as lupus nephritis, hypertension, and thrombocytopenia have traditionally dominated risk assessments, new findings presented at EULAR 2025 spotlight the critical—and often underrecognized—role of social determinants of health (SDOH) in shaping maternal outcomes
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Pregnancy outcomes in autoinflammatory disease
To address this, a French multi-centre prospective pregnancy observational cohort was set up, to analyse disease activity, treatment, pregnancy outcomes, delivery, and neonatal health. The work – presented at the 2025 annual https://t.co/oQ7A2bnDmO
Dr. John Cush @RheumNow( View Tweet )
Add-on certolizumab in pregnant women with APS
Women with antiphospholipid syndrome and lupus anti-coagulant are at high risk of developing adverse pregnancy outcomes (APO). Usual care includes low molecular weight heparin (LMWH) and low dose aspirin (LDA). Despite these therapies, APO have been reported up to 40%. An important
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Pregnancy outcomes in autoinflammatory disease
EurekAlert!
To address this, a French multi-centre prospective pregnancy observational cohort was set up, to analyse disease activity, treatment, pregnancy outcomes, delivery, and neonatal health. The work – presented at the 2025 annual congress of EULAR – showcased findings from 97 women with an
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Management of SLE:
-Treat early to prevent organ damage
-Taper GC to <5mg/d in the first 6m when feasible
-New therapies are promising but still unmet needs in LN, limited global access and lacking data in pregnancy.
#EULAR2025 @RheumNow https://t.co/UKK8sTYJD2
Links:
Adela Castro @AdelaCastro222( View Tweet )
PsA asso w/ higher risk of preterm births in women
Scandinavian registries
688 PsA pregnancies
8% preterm births vs. 4.5% general population OR 1.8
16.4% if bDMARD combination OR 4
3.1% if bDMARD monotherapy OR 0.7
bDMARDs combo probably a surrogate of high disease activity
Aurelie Najm @AurelieRheumo( View Tweet )
#EULAR2025 Abstr#OP0273 Single arm, Open Label Phase 2 trial showed Certolizumab (given in WKS 8-28) +LMWH+LDA in Antiphospholipid syndrome reported 20% Adverse Pregnancy Outcomes in ITT; 18% Per Protocol. Met prespecified criterion (20%); expected LMWH+LDA (40%) @RheumNow https://t.co/ynQ2h2NTQ7
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
#EULAR2025 Abstr#POS0991 RCT showed Adjuvanted Herpes Zoster vaccination appeared safe in #SLE upto 1 year. However, humoral and cellular responses declined over time. Longer follow up needed to ascertain frequency of vaccine to be repeated @RheumNow https://t.co/FcUi1OfBLu
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
So much needed in SLE and pregnancy
1. Risk stratification at diagnosis
2. Pregnancy counseling at dx and >1 y before pregnancy
3. Close collab with GYN necessary
4. Challenging management given gaps in evidence.
#EULAR2025 #asktheexpert @RheumNow https://t.co/MXGkKpl452
Links:
Adela Castro @AdelaCastro222( View Tweet )
MTX Fails Knee OA (6.6.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com
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Autoimmunity Rising in Expectant Mothers
Lancet Rheumatology has published a UK study showing a significant increased in the number of expectant mothers beginning their pregnancies with autoimmune conditions.
The MuM-PreDiCT project run by the University of Birmingham, analyzed the electronic healthcare records from
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Lupus Unlocked: Pregnancy and SLE
In this webinar, panelists discussed issues such as congenital heart block, lupus nephritis treatment, teratogenic risks including conception on mycophenolate, antiphospholipid syndrome, hypertension management including the differential https://t.co/0RfAH7jW0J
Dr. John Cush @RheumNow( View Tweet )
IMPACT Study - Certolizumab Efficacy in APS Pregnancies
A pilot trial assessed the safety and value of tumour necrosis factor α inhibitor treatment with certolizumab in patients with high-risk pregnancies with antiphospholipid syndrome (APS). Certolizumab (CZP) was shown to https://t.co/sbXW6vNX5y
Dr. John Cush @RheumNow( View Tweet )
MMWR: 1994 the U.S. Vaccines for Children program has covered the cost of vaccines for US children. Since 1994 routine child vaccinations will have prevented ~508 million illness, 32 million hospitalizations, & 1,129,000 deaths,; direct savings of $540 billion & societal savings https://t.co/JCeSFmIgxV
Dr. John Cush @RheumNow( View Tweet )
Biologics in Pregnancy Patients With Autoimmune Disease
A large cohort, claims data study shows that among pregnant women receiving biologic therapies for autoimmune conditions, 72% continued their biologics pregnancy, more so among inflammatory bowel disease (IBD) patients https://t.co/CH60gShlH0
Dr. John Cush @RheumNow( View Tweet )
SLE, Antiphospholipid Antibodies, and the Placenta
It is well established that women with SLE are at increased risk for adverse pregnancy outcomes, including preeclampsia, preterm birth, and pregnancy loss. However, the pathophysiologic mechanisms driving these complications https://t.co/z0BOT3xsuQ
Dr. John Cush @RheumNow( View Tweet )
Lupus Unlocked: Pregnancy & SLE
📅 May 27, 2025
6:00 PM CT | 7:00 PM ET | 4PM PT
Join us for our final Lupus Unlocked webinar this month on pregnancy and SLE. In this webinar, panelists will discuss issues such as congenital heart block, lupus nephritis treatment, teratogenic https://t.co/gouTN7uzCo
Dr. John Cush @RheumNow( View Tweet )
controversy re
👇
Monitoring for +Ro pregnant re
#congenital #heart #block
87% Y
echo is possibly too late
No ideas if flourinated #steroids work
But many thing we should do something
Guidelines differ on recommendations
Would fetal home HR be better
#LUPUS2025 @RheumNow https://t.co/MY0oPjLnGs
Janet Pope @Janetbirdope( View Tweet )
Diagnosing Neuropsychiatric SLE (5.23.2025)
Dr. Jack Cush reviews the news and journal reports from RheumNow.com - including views on the vagus nerve, NPSLE and CAR-T mania.
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