In a small-scale study, researchers found that no, or minimal amounts of, certolizumab pegol transfers from mothers taking the drug to nursing infants…
Rheumatologists Should Discuss with Patients Use of Immunomodulatory Agents During Pregnancy
The decision to continue or discontinue immunomodulatory medications during pregnancy is a difficult one for both patients and physicians. On the one hand, when left untreated, rheumatic conditions can cause harm to an unborn child, as well as to the pregnant mother. On the other hand, medications can be harmful to a developing fetus. In…
Tacrolimus Use for Lupus Nephritis Raises Debate over Role in North American Population
The following summary regarding use of tacrolimus (TAC) in lupus nephritis highlights a number of debatable points. Although the role of TAC in lupus nephritis remains unproved for North American populations, it might be an excellent option in some clinical situations. These situations include lupus flare during pregnancy and also for lupus nephritis when the…
Pregnancy Outcome in Early Rheumatic Disease
Systemic autoimmune rheumatic diseases are associated with increased rates of adverse pregnancy outcomes, including spontaneous abortion, preeclampsia, fetal growth restriction (FGR) and prematurity. In this study population, preclinical rheumatic disorders were associated with an increased risk of FGR, preeclampsia and small-for-gestational-age infants. The impact of these findings and their utility in screening for fetal growth restriction/preeclampsia need to be confirmed in population studies…
Antiphospholipid Antibody Syndrome Puts Pregnant Women at High Risk of Preeclampsia
A recent review investigated risk factors for preeclampsia in early pregnancy, finding that antiphospholipid antibody syndrome may be the strongest risk factor. As a result of these findings, researchers have compiled a list of risk factors to help clinicians determine which women are more likely to develop the condition and aid them in weighing treatment options…
Adalimumab & Infliximab Remain in Newborns after Delivery
A recent study showed that, when administered during pregnancy, infliximab takes longer to clear an infant’s system than adalimumab…
Extra Bone Resorption in Pregnancy, Lactation May Pass Maternal Lead Burden to Baby
NEW YORK (Reuters Health)—Bone resorption increases during pregnancy and continues to be high postpartum, according to new findings using lead testing to measure bone turnover. Researchers also found unexpected evidence that maternal lead burden is transferred to the fetus. “These data confirm calcium balance studies that indicate increased bone resorption throughout pregnancy and lactation,” Dr….
TNF Blocking Drugs Persist in Infants after Exposure In-Utero
NEW YORK (Reuters Health)—Babies born to mothers who took anti-tumor necrosis factor (anti-TNF) agents during pregnancy have detectable drug in their bodies up to 12 months of age, new findings show. These infants should therefore not receive live vaccines during their first year of life, Dr. Mette Julsgaard of Aarhus University Hospital in Denmark and…
From the Expert: New Insights into Treating Pregnant Patients with Rheumatic Disease
The approach of under-treating rheumatic disease in pregnant patients is changing, according to Bonnie Lee Bermas, MD. Dr. Bermas discusses with The Rheumatologist the need for more research on how drugs affect this patient group, and how timing of conception and disease stability play important roles in the safe outcomes of mother and infant…
APS: What Rheumatologists Should Know about Hughes Syndrome
The problem that dogs the work of all of those treating patients with antiphospholipid syndrome (APS) is the apparent lack of knowledge of the syndrome, both by the general public, as well as by swaths of the medical fraternity. Perhaps it was ever thus—a syndrome less than 40 years old could be described as new,…
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