scholarly journals REACTIVATION OF BRUCELLOSIS AND RHEUMATOID ARTHRITIS IN PREGNANCY

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Chimed-Ochir Odgerel
Keyword(s):  
Rheumatoid Arthritis ◽  
In Pregnancy

scholarly journals AB0302 USE OF TNF-INHIBITORS BEFORE, DURING AND THE FIRST YEAR AFTER PREGNANCY AMONG WOMEN WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1450.2-1450
Author(s):  
H. Bjørngaard ◽  
H. Koksvik ◽  
B. Jakobsen ◽  
M. Wallenius
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Post Partum ◽  
Tnf Inhibitors ◽  
Treat To Target ◽  
Inflammatory Rheumatic Diseases ◽  
Tnf Inhibitor ◽  
Rheumatic Arthritis ◽  
Quality Register ◽  
In Pregnancy

Background:Treat to target is a goal, also in pregnant women with Rheumatoid arthritis (1). There is increasing evidence on safe use with TNF inhibitors during pregnancy. Adjusted use of TNF inhibitors preconception and throughout pregnancy may stabilize disease activity and prevent flares (2). Low disease activity is also beneficial for the fetus.Objectives:To study the use of TNF-inhibitors among women with Rheumatic arthritis during and after pregnancy.Methods:RevNatus is a Norwegian, nationwide quality register that monitors treatment of inflammatory rheumatic diseases before, during and after pregnancy. Data from RevNatus in the period October 2017 to October 2019 was used to map the use of all types of TNF inhibitors among 208 women with rheumatoid arthritis, diagnosed by the ACR/EULAR criteria. The use of medication was reported at the time of visit in outpatient clinic. The frequency of use of TNF inhibitors registered at seven timepoints from pre-pregnancy to twelve months after delivery.Results:The use of medication was reported at each visit for all the women with rheumatoid arthritis. Most of the women were not using TNF inhibitors before and beyond conception. Most of the women continuing TNF inhibitors beyond conception used certolizumab or etanercept. Adalimumab and infliximab were used in pregnancy (tabell 1).Tabell 1.certoliz-umabetane-rceptadalim-umabgolim-umabinflixi-mabNo TNF-inhibitorBefore pregnancyn=10521% (22)9% (10)3% (3)1% (1)66% (69)1.trimestern=8119% (15)10% (8)71% (58)2.trimestern=8810% (9)10% (9)80% (70)3.trimestern=9111% (10)5% (5)83% (76)6 weeks post partum n=9622% (21)13% (13)1% (1)1% (1)63% (60)6 months post partum n=8824% (21)18% (16)4% (4)1% (1)53% (46)12 months post partum n=8421% (18)17% (15)7% (6)2% (2)53% (43)Conclusion:Most of the women with rheumatic arthritis were not treated with TNF inhibitors before or in pregnancy. Women with rheumatic arthritis that continuing treatment with TNF inhibitors through pregnancy were using certilozumab and etanercept.References:[1]Gotestam Skorpen C, Hoeltzenbein M, Tincani A, Fischer-Betz R, Elefant E, Chambers C, et al. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. 2016;75(5):795-810.[2]van den Brandt S, Zbinden A, Baeten D, Villiger PM, Ostensen M, Forger F. Risk factors for flare and treatment of disease flares during pregnancy in rheumatoid arthritis and axial spondyloarthritis patients. Arthritis Res Ther. 2017;19(1):64.Disclosure of Interests:None declared

Rheumatology

2020 ◽  
pp. 263-306
Author(s):  
Charlotte Frise ◽  
Sally Collins
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Systemic Sclerosis ◽  
Psoriatic Arthritis ◽  
Ankylosing Spondylitis ◽  
Lupus Erythematosus ◽  
Pregnant Patient ◽  
Systemic Lupus ◽  
Musculoskeletal Problems ◽  
In Pregnancy

This chapter covers rheumatic diseases in the pregnant patient. It gives background, clinical features, and management in the pregnant patient for rheumatoid arthritis, Sjögren’s syndrome, psoriatic arthritis, systemic lupus erythematosus, antiphospholipid syndrome, and ankylosing spondylitis among others. It also covers systemic sclerosis, osteoporosis, and other musculoskeletal problems. Medications and the use of biologics in pregnancy are also discussed, with reference to breastfeeding.

Rheumatoid arthritis

2018 ◽  
pp. 243-264
Author(s):  
Gavin Clunie ◽  
Nick Wilkinson ◽  
Elena Nikiphorou ◽  
Deepak R. Jadon
Keyword(s):  
Rheumatoid Arthritis ◽  
Mechanism Of Action ◽  
Clinical Manifestations ◽  
Holistic Treatment ◽  
Key Points ◽  
Special Circumstances ◽  
In Pregnancy

This chapter describes the presenting features, clinical manifestations, and management of rheumatoid arthritis. Commonly used investigations, their indication and interpretation, as well as the holistic treatment of rheumatoid arthritis are outlined. A summary of the commonly used drugs for the treatment of rheumatoid arthritis, their mechanism of action, and key points for starting and monitoring their use is included. Special circumstances including the management of rheumatoid arthritis in pregnancy, surgery, vaccinations, and during infections are also discussed.

A Population-level Analysis of the Differing Effects of Rheumatoid Arthritis and Spondyloarthritis on Peripartum Outcomes

2019 ◽  
Vol 47 (2) ◽  
pp. 197-203 ◽  
Author(s):  
Stephanie O. Keeling ◽  
Samantha L. Bowker ◽  
Anamaria Savu ◽  
Padma Kaul
Keyword(s):  
Rheumatoid Arthritis ◽  
Pregnant Women ◽  
Population Level ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Neonatal Outcomes ◽  
Hypertensive Disorder ◽  
Antiinflammatory Drugs ◽  
Hypertensive Disorders ◽  
Maternal And Neonatal Outcomes ◽  
In Pregnancy

Objective.The effects of rheumatoid arthritis (RA) and spondyloarthritis (SpA) on maternal and neonatal outcomes at a population level have not previously been well compared.Methods.A contemporary pregnancy cohort of 312,081 women and corresponding birth events was assembled for the province of Alberta from the random selection of 1 live birth event per woman. We identified 3 groups: (1) no inflammatory arthritis (no IA, n = 308,989), (2) RA (n = 631), and (3) SpA (n = 2461). We compared maternal and neonatal outcomes, comorbid conditions, and medication use among the 3 groups. Multivariable logistic regression models evaluated the independent association between RA and SpA, relative to no IA, and the outcomes of small for gestation age (SGA) and hypertensive disorders during pregnancy.Results.Pregnant women with RA were significantly more likely to have preterm delivery (13.5%), cesarean delivery (33.9%), hypertensive disorders in pregnancy (10.5%), and SGA babies (15.6%), compared to pregnant women with either SpA or no IA. Nonsteroidal antiinflammatory drugs and corticosteroid use were significantly higher in pregnant women with RA compared to the other groups. Women with RA were significantly more likely to have an SGA baby (OR 1.51, 95% CI 1.21–1.88; p < 0.01), and hypertensive disorder in pregnancy (OR 1.51, 95% CI 1.16–1.97; p < 0.01), compared to women with no IA, while no difference was found between women with SpA and those with no IA.Conclusion.Women with RA have a higher risk of worse maternal and neonatal outcomes, whereas the risk of these events is similar between women with and without SpA.

scholarly journals CHARACTERIZATION OF A HUMAN ACUTE PHASE PROTEIN FOUND IN ASSOCIATION WITH RUBELLA VIRUS INFECTION

1974 ◽  
Vol 139 (3) ◽  
pp. 497-511 ◽  
Author(s):  
Roger Cappel ◽  
Ann Schluederberg ◽  
Robert H. Gifford ◽  
Dorothy M. Horstmann
Keyword(s):  
Rheumatoid Arthritis ◽  
Virus Infection ◽  
Acute Phase ◽  
Rubella Virus ◽  
Acute Phase Protein ◽  
Phase Protein ◽  
Rubella Virus Infection ◽  
In Pregnancy

A precipitating antigen, rho, was first detected in the blood of persons with rubella and in rubella virus-infected cell culture fluids (1). Partially purified antigens from both sources were examined and shown to have similar properties, although antigen from serum sedimented more heterogeneously, with estimated coefficients from 15 to 21 S, while that from culture fluids sedimented in the 11–14 S region. In each case, antigen was located in the ß-1 zone after electrophoresis in agarose, and at a density of 1.305 g/ml after centrifugation in CsCl. Stability characteristics were typical of protein antigens. Immunofluorescent microscopy revealed that rubella virus induced the appearance of rho antigen scattered throughout the cytoplasm of infected cells. When cells containing antigen were exposed for 24 h to 5 µg/ml actinomycin D rho was no longer detectable, indicating the probable cellular origin of the antigen. Also, titers in medium of infected cultures showed a reduction after actinomycin treatment, but levels of the virus-specified antigen, iota, were relatively unaffected. Rho appears to be a protein common to man and many animals. In vitro, it was induced by rubella virus and by adenovirus. In vivo, rho titers were shown to be elevated after rubella virus infection and, to a lesser extent, after infection with certain other viruses. High titers were also demonstrated in women late in pregnancy and in patients with rheumatoid arthritis. In man and the chimpanzee, the appearance and decline of rho in the blood after rubella virus infection were temporally similar to the patterns of CRP, although rho seemed to be a more sensitive indicator of infection. The data presented indicate that rho is a newly recognized acute phase protein inducible by certain virus infections and by other unidentified stimuli present prominently in pregnancy and rheumatoid arthritis.

scholarly journals Searching for a placental derived ES-62-like molecule to explain rheumatoid arthritis amelioration in pregnancy

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Craig D. Scoville ◽  
Devon Rasmussen
Keyword(s):  
Rheumatoid Arthritis ◽  
Mass Spectrometry ◽  
Animal Models ◽  
Heavy Chain ◽  
Protein Identification ◽  
Cross Reactivity ◽  
Primary Sequence ◽  
Reduce Disease Activity ◽  
Filarial Nematodes ◽  
In Pregnancy

The majority of women with rheumatoid arthritis (RA) experience disease amelioration during pregnancy for unclear reasons. One possible explanation pursued and described here is whether the placenta produces a protein similar to the immunomodulating protein, ES-62, excreted by filarial nematodes. This protein has also been shown to reduce disease activity in animal models of RA. Eleven human placentas were prepared and a polyclonal anti-ES-62 antiserum was used to identify if any ES-62-like molecule exists from human placental tissues. Any bands identified were then excised from the gel and sent for mass spectrometry and protein identification. The anti-serum showed consistent cross reactivity with the heavy chain from immunoglobulin G (IgG) from the eleven human placentas by mass spectrometry. No primary sequence homology between the heavy chain of IgG and ES-62 was identified. The placenta does not produce an ES-62-like molecule. However the binding of the antiserum to the Fc region of IgG suggests that this may be a possible mechanism for rheumatoid factor production in some patients with chronic filarial infections.

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