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Pregnancy

Infection Risk in Offspring Exposed to Biologics: Dr. Rachel Tate ( @uptoTate)https://t.co/oYpKpCix7Q https://t.co/0yIk9Qhc1h
Dr. John Cush @RheumNow( View Tweet )
Nov 26, 2021
rachel.tate

Safety of Psoriatic Biologics in Pregnancy

Nov 24, 2021

Little is known about the safety of newer biologic use during pregnancy, especially in patients who either conceive while on a biologic or must remain on a biologic during pregnancy (often the case with IBD and inflammatory arthritis). A report from ACR 2021 (Abstract 1713) examined the risk

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SpA & Pregnancy Outcomes? ➡️SpA pts txed w/ bDMARDs at conception are not at higher risk for adverse pregnancy outcomes compared to those w/o bDMARD ➡️Stopping bDMARDs after conception assoc w/ ↑ dz activity during pregnancy + after birth & ↑flares Abst#1730 #ACR21 @RheumNow https://t.co/Y4c7vI0cgS
Meral K. El Ramahi, MD @MeralElRamahiMD( View Tweet )
Nov 09, 2021
RHEKISS registry: SpA pts on bDMARDs at conception are NOT at inc. risk for adverse pregnancy outcomes. Discontinuation of bDMARDs after conception is assoc'd w/ inc. dz activity during/after pregnancy & flare risk. Abs 1730 #ACR21 #RheumNow @RheumNow https://t.co/b2wI9GZios https://t.co/wsuvv3hF0v
Dr. Rachel Tate @uptoTate( View Tweet )
Nov 09, 2021
Pregnant pts w/ PsA, but not AxSpA, at increased risk of pre-eclampsia. In RA pregnancies, pre-eclampsia risk increases w/ dz severity prior/during pregnancy. We need to discuss potential risks w/ pts and OB team. Abs 1722 #ACR21 #RheumNow @RheumNow https://t.co/yeQmNAZ1jV https://t.co/cBfeVKQHfr
Dr. Rachel Tate @uptoTate( View Tweet )
Nov 09, 2021
No clear excess risk for offspring exposed in-utero to, VED or TNFi's. UST showed infection signal BUT w/ wide CIs. We need more research re: biologics and placental transmission potential/subsequent risks. Abs 1713 #ACR21 #RheumNow #ACRbest @RheumNow https://t.co/W3K5uDyHlC

Dr. Rachel Tate @uptoTate( View Tweet )

Nov 09, 2021
#ACR21 #Abstr1492 Could gut microbiome contribute to Anti-Ro+/autoimmunity in #lupus? Analyses of 125 stool samples from mother of children with neonatal lupus and/or heart block revealed its potential role in genetic-environment interaction @RheumNow https://t.co/FnJtZJSCRj https://t.co/ttRdP9NIrG
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
Nov 09, 2021
Meds men with rheum dz can use while trying to getting their partners pregnant #acr21 ⁦@RheumNow⁩ https://t.co/RlcPakappk
TheDaoIndex @KDAO2011( View Tweet )
Nov 07, 2021
Review of ACR Reproductive Guidelines by Dr. Talabi #ACR21 #ACRAmbassador https://t.co/x2xCSnxpJ2
Veena Katikineni @VeenaRheumMD( View Tweet )
Nov 07, 2021
"Healthier moms lead to healthier babies. This is how I frame the discussion regarding medications and PsA in my practice (with regard to reproductive health)." Dr. Talabi #ACR21 @RheumNow #RheumNow

Dr. Rachel Tate @uptoTate( View Tweet )

Nov 07, 2021
ACR Best

ACR21 Best Abstracts - Day 1

Nov 07, 2021

The RheumNow faculty have been glued to their monitors all day, watching video, and running down abstract presentations to find the best – several of these stood out as #ACRBests. Here is a listing of “Best” they saw on Day 1.

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Dr B Bermas noted AAP guidelines say avoid MTX while breastfeeding, but the literature show very little MTX crosses breast milk. Dr Sammaritano stated that is true, but we don’t know how much MTX accumulates,though. #acr21 @rheumnow @UTSWRheum https://t.co/9I7HszorEO
TheDaoIndex @KDAO2011( View Tweet )
Nov 06, 2021
Would you allow a pt to continue MTX while breastfeeding? #acr21 @rheumnow

TheDaoIndex @KDAO2011( View Tweet )

Nov 06, 2021
#ACR2021 Dr. L Sammaritano shows evidence for using belimumab during breastfeeding @RheumNow https://t.co/kDXXauoOZQ
Donald Thomas, MD @lupuscyclopedia( View Tweet )
Nov 06, 2021
Remember: IUDs are the easiest contraception to recommend to SLE patients... Sammaritano lecture going on now #ACR2021 @RheumNow https://t.co/ZGRFIZyf5h
Donald Thomas, MD @lupuscyclopedia( View Tweet )
Nov 06, 2021
Irish registry of AS pts included 76 women who were pregnant ⭐️58% uncomplicated, 41.9% complicated, 11% multiple complications ⭐️frequency of miscarriage ⬆️ ⭐️complications included C-section, preterm, NICU admission #ACR21 @RheumNow Abs#369 https://t.co/90dolEeTIw
Robert B Chao, MD @doctorRBC( View Tweet )
Nov 06, 2021
Lupus Nephritis in pregnancy: @HopkinsRheum Petri recommendations ⭐️AZA safe for LN, with tacro if needed ⭐️❌Voclosporin (alcohol content) ⭐️Belimumab uncertain @Rheumnow #ACR21 Great Debate
Nov 06, 2021
#ACR21 #ACR2021 Rheumatology Reproductive Health 👉🏻 Biologics and breast milk 👉🏻 Good vaccine response with TNFi (like with covid vaccines ) 👉🏻 ustekimumab seems safe in pregnancy 👉🏻 Tofacitinib/ small molecules may cross placenta/ be in breast milk ➡️ contraindicated in preg/BF https://t.co/qk3sLR4QHz
EnvisionRheumat @ERheumat( View Tweet )
Nov 06, 2021
ASRI data: high frequency of pregnancy and fetal complications (miscarriage, c-section, early delivery, NICU admission) in AxSpA pts. We need more studies regarding risks/tx/outcomes/breastfeeding guidance. Abs 0369 #ACR21 #RheumNow @RheumNow https://t.co/4BR2ZPPjyB https://t.co/qyTwtfEMMy
Dr. Rachel Tate @uptoTate( View Tweet )
Nov 06, 2021
@jhrheumatology Dr. Petri at #ACR21 Great Debate. Safety issues with Voclosporin: 1) Nephrotoxicity 2) Infection 3) CV Risk Factors 4) Malignancy 5) Neurologic toxicity 6) Osteoporosis 7) Drug interactions 8) Deaths 9) Pregnancy contraindication @RheumNow https://t.co/wjluivmKNt
Nov 06, 2021
Is holding MTX during breastfeeding overblown? @MotherToBaby data showed that infants get 0.4% of mom’s dose 24 hrs post-MTX dose. Skip breastfeeding 1 day post-MTX may be safe. Consider monitoring infant CBC. Studies needed to follow infants longitudinally #ACR21 @rheumnow https://t.co/ikJvkk5BjI
TheDaoIndex @KDAO2011( View Tweet )
Nov 06, 2021
Dr. Chambers review @MotherToBaby prospective data on HCQ use in pregnancy (n=279): 👉no major defects (regardless of dose) 👉no oral clefts 👉SGA slightly lower in exposed group b/c of underlying dz 👉no case of retinopathy in babies after 1 year f/u @rheumnow #Pregnancy https://t.co/vw2eryFgro
TheDaoIndex @KDAO2011( View Tweet )
Nov 06, 2021
Dr. Chambers reviewed @MotherToBaby data of pregnant rheum women during the pandemic noted: ⬆️EtOH use in pregnancy, ⬆️stress, anxiety, depression ⬆️obesity ⬇️likelihood to get prenatal care #ACR21 @rheumnow #RheumPregnancy https://t.co/GCYCIuiunS
TheDaoIndex @KDAO2011( View Tweet )
Nov 06, 2021
Which of the following would you d/c in the 3rd trimester of pregnancy? #ACR21 #Pregnancy @rheumnow

TheDaoIndex @KDAO2011( View Tweet )

Nov 06, 2021
Experts (Drs. M Clowse, Sammaratino) limit mAb TNFi 1 month b/f delivery or extend dosing. But, they do dose again for flares. Risk for infection is low based on the PIANO registry. Postpartum, they restart the meds w/in 1 week (vag delivery), 2 weeks C/S @rheumnow #pregnancy

TheDaoIndex @KDAO2011( View Tweet )

Nov 06, 2021
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