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Pregnancy

Very low & very high vitamin D (25/OH) levels assoc w/ adverse pregnancy outcomes - miscarriage (P = 0.0045) & preterm delivery (P = 0.0007). APO were lowest w/ 25(OH)D levels of 40 to 59 ng/mL. Monitor vit D and Rx during SLE pregnancies https://t.co/Z9jEgETqId https://t.co/fJRqD3v7UF
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Contraception in SLE Pregnancy in SLE receives significant attention in rheumatology due to increased risks. Historically, women with SLE were advised against pregnancy. As of 2004, the maternal mortality rate was 20 times higher than the general population. Although recent https://t.co/89df0TKtF5
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EULAR Guidelines on Reproductive Health Rheumatology patients considering or actually having babies can safely take most of the medications currently used to treat their conditions, according to an updated guideline from the European Alliance of Associations for Rheumatology https://t.co/121I7Yb8Ki
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Keys to Mastery (5.2.2025)

Dr. Jack Cush reviews the news, articles and drug approvals from the past week on RheumNow.com. This podcast marks the beginning of our Lupus Campaign called "Lupus Unlocked: Keys to Mastery". This month's campaign on Lupus is sponsored by Aurinia.

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Contraception in SLE

Pregnancy in SLE gets a lot of press in the rheumatology literature, and deservedly so, since pregnancy risks can be markedly increased. It was not that many years ago that women with SLE were counseled to avoid pregnancy. As recently as 2004, the maternal mortality rate in SLE was 20-fold

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EULAR Guidelines on Reproductive Health

MedPage Today

Rheumatology patients considering or actually having babies can safely take most of the medications currently used to treat their conditions, according to an updated guideline from the European Alliance of Associations for Rheumatology (EULAR).

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Norwegian RevNatus Pregnancy study on 417 births in 350 women w/ axSpA: 86% (347) were breastfeeding @6wks, 70% @6mos, & 38% @12 mos. Non-breastfeeders more likely to have C-section (41 vs 20%), higher ASDAS-CRP (2.6 vs 2.2), CRP (5.3 vs 3.3), & VAS pain (41 vs 32) https://t.co/DI6owL5dof
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Norwegian RevNatus Pregnancy study on 417 births in 350 women w/ axSpA: 86% (347) were breastfeeding @6wks, 70% @6mos, & 38% @12 mos. Non-breastfeeders more likely to have C-section (41 vs 20%), higher ASDAS-CRP (2.6 vs 2.2), CRP (5.3 vs 3.3), & VAS pain (41 vs 32) https://t.co/GhLtLqT0iS
Dr. John Cush @RheumNow( View Tweet )
Vitamin D for Prevention of Disease JAMA has published a clinical guideline on the use of vitamin D to prevent disease in children and adults. Guideline committee experts, included adult and pediatric endocrinology, internal medicine, obstetrics/gynecology, nutrition, and https://t.co/zi3CpE0DVN
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Rheumatology: Believe It or Not (4/25/2025)

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Should we believe the reviews and metanalyses?

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A review of 18 guideline recommendations on DMARDs in pregnancy & reproductive health. There were recs. DMARDs & pre-conception (56%), lactation (67%), male fertility (33%), & use of csDMARDs (72%), bDMARDs(72%), tsDMARDs (28%); less recs for b/tsDMARD use https://t.co/tKGCXrbOuc
Dr. John Cush @RheumNow( View Tweet )
If you see women with inflammatory arthritis who are pregnant or planning a pregnancy, the MAMA Study may be recruiting at an obstetric unit near you. To find out what is happening, visit @TheMAMAStudy, https://t.co/N8B5MpTsRx, or email mama@npeu.ox.ac.uk. @NPEU_CTU @NPEU_Oxford https://t.co/lQdgUiZ0Cb
Should Lupus Nephritis Receive PJP Prophylaxis? A current review article suggests that the need for Pneumocystis jirovecii pneumonia (PJP) prophylaxis in patients with systemic lupus erythematosus (SLE) and lupus nephritis will need to be individualized based on therapies and https://t.co/QGHxk3O8q4
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Systematic review of >90 studies on Pregnancy and RA risk indicates that parity, gravidity, infertility, pregnancy loss do not adversely affect RA development. But low birthweight was assoc w/ RA Dx/severity, and pre-eclampsia incr risk of subsequent RA Dx. https://t.co/nw8FfWyM8A
Dr. John Cush @RheumNow( View Tweet )
Systematic review of >90 studies on Pregnancy and RA risk indicates that parity, gravidity, infertility, pregnancy loss do not adversely affect RA development. But low birthweight was assoc w/ RA Dx/severity, and pre-eclampsia incr risk of subsequent RA Dx. https://t.co/jVa4tmSqvj
Dr. John Cush @RheumNow( View Tweet )
Pregnancy-Related Deaths in the US A CDC cross-sectional national study showed an increase in pregnancy-related deaths in the US from 2018 to 2022, with highest rates among American Indian, Alaska Native women, and non-Hispanic Black women. https://t.co/H1s649GyiL https://t.co/MXnrQrAcrT
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Pregnancy-Related Deaths in the US

A CDC cross-sectional national study showed an increase in pregnancy-related deaths in the US from 2018 to 2022, with highest rates among American Indian, Alaska Native women, and non-Hispanic Black women. 

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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/MaWx6AZ0JF
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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
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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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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/2dcFVgu8z6https://t.co/RyCdiadn4H https://t.co/EvWcQ6KIxQ
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