Scholars@Duke
Megan Elizabeth Bowles Clowse

Megan Elizabeth Bowles Clowse

Professor of Medicine
Medicine, Rheumatology and Immunology
megan.clowse@duke.edu
Duke Box 3535, Durham, NC 27710
Baker House 07, Duke South, Trent Drive, Durham, NC 27710

Selected Publications

Perspectives of Rheumatologists on the Type 1 and 2 Systemic Lupus Erythematosus Model.

Journal Article ACR Open Rheumatol · December 2024 OBJECTIVE: The Type 1 and 2 systemic lupus erythematosus (SLE) Model was developed to encapsulate all signs and symptoms that patients with SLE experience. Our previous qualitative work demonstrated the model accurately reflects the lived experience of peo ... Full text Link to item Cite

Reproductive Outcomes for Women With Vasculitis.

Journal Article J Rheumatol · October 1, 2024 OBJECTIVE: There are limited data on the reproductive health of women with vasculitis. This study used a prospective, international vasculitis pregnancy registry to survey women during and after pregnancy. METHODS: The Vasculitis Pregnancy Registry (VPREG) ... Full text Link to item Cite

Exploring Reproductive Experiences With Women Enrolled in the International Vasculitis Pregnancy Registry.

Journal Article J Rheumatol · October 1, 2024 OBJECTIVE: This study explored the reproductive journeys of women with vasculitis, including their conversations with healthcare providers, disease activity, medication changes, and delivery experiences. METHODS: Interviews were conducted with women regist ... Full text Link to item Cite

Pregnancy Outcomes in Patients Treated with Upadacitinib: Analysis of Data from Clinical Trials and Postmarketing Reports.

Journal Article Drug Saf · October 2024 BACKGROUND AND OBJECTIVE: Upadacitinib is indicated for diseases affecting persons of childbearing potential including rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis, atopic dermatitis, Crohn's disease, and ulcerative colitis; however, ... Full text Link to item Cite

Using linked electronic medical record-pharmacy data to examine lupus medication adherence: A retrospective cohort study.

Journal Article Lupus · October 2024 INTRODUCTION: Medication nonadherence is common in systemic lupus erythematosus (SLE) and associated with morbidity and mortality. We explored the reliability of pharmacy data within the electronic medical record (EMR) to examine factors associated with no ... Full text Link to item Cite

The Impact of Pregnancy Readiness on Lupus Activity, Maternal Mental Health, and Pregnancy Outcomes.

Journal Article Arthritis Care Res (Hoboken) · September 8, 2024 OBJECTIVE: Among individuals with systemic lupus erythematosus (SLE) who became pregnant, we explored the impact of medical readiness for pregnancy and personal readiness for pregnancy on the following aspects of maternal health: (1) provider-reported dise ... Full text Link to item Cite

Implementation of a Clinician-led Medication Adherence Intervention Among Patients With Systemic Lupus Erythematosus.

Journal Article J Rheumatol · September 1, 2024 OBJECTIVE: Medication nonadherence in systemic lupus erythematosus (SLE) leads to poor clinical outcomes. We developed a clinician-led adherence intervention that involves reviewing real-time pharmacy refill data and using effective communication to addres ... Full text Open Access Link to item Cite

Alignment of contraception use with the ACR reproductive health guidelines in women with systemic lupus erythematosus within the RISE registry.

Journal Article Lupus Sci Med · August 24, 2024 OBJECTIVES: Contraception is crucial for safely timing pregnancies in patients with SLE. This study investigated predictors of contraception documentation in patients with SLE, and the alignment of contraception practices with the 2020 American College of ... Full text Link to item Cite

Evaluating Factors Associated With Telehealth Appropriateness in Outpatient Rheumatoid Arthritis Encounters Using the Encounter Appropriateness Score for You (EASY).

Journal Article J Rheumatol · August 1, 2024 OBJECTIVE: Telehealth has been proposed as a safe and effective alternative to in-person care for rheumatoid arthritis (RA). The purpose of this study was to evaluate factors associated with telehealth appropriateness in outpatient RA encounters. METHODS: ... Full text Open Access Link to item Cite

The time of equipoise on the use of biological DMARDs in for inflammatory arthritis during pregnancy is finally over: a reappraisal of evidence to optimise pregnancy management

Journal Article The Lancet Rheumatology · August 1, 2024 Active inflammatory arthritis in pregnancy is associated with an increased risk of adverse pregnancy outcomes. Treatment of active inflammation and maintenance of low disease activity with medication reduces these risks. Therapeutic decisions on disease-mo ... Full text Cite

Patient and Physician Perspectives of Systemic Lupus Erythematosus Flare: A Qualitative Study.

Journal Article J Rheumatol · May 1, 2024 OBJECTIVE: Systemic lupus erythematosus (SLE) flares are associated with increased damage and decreased health-related quality of life. We hypothesized that there is discordance between physicians' and patients' views of SLE flare. In this study, we aimed ... Full text Link to item Cite

Interpreting hydroxychloroquine blood levels for medication non-adherence: a pharmacokinetic study.

Journal Article Lupus Sci Med · April 30, 2024 OBJECTIVE: Characterise the relationship between hydroxychloroquine (HCQ) blood levels and the number of missed doses, accounting for dosage, dose timing and the large variability in pharmacokinetics (PK) between patients. METHODS: We externally validated ... Full text Link to item Cite

Evaluation of Type 2 SLE symptoms in patients with a range of lupus nephritis activity.

Journal Article Clin Rheumatol · April 2024 BACKGROUND: Type 2 systemic lupus erythematosus (SLE) symptoms, including fatigue, fibromyalgia, and brain fog, contribute to poor health-related quality of life (HRQoL) in patients with lupus. To test the hypothesis that Type 1 (classical inflammatory lup ... Full text Link to item Cite

Impact of preeclampsia on infant and maternal health among women with rheumatic diseases.

Journal Article Lupus · April 2024 OBJECTIVES: We sought to identify the impact of preeclampsia on infant and maternal health among women with rheumatic diseases. METHODS: A retrospective single-center cohort study was conducted to describe pregnancy and infant outcomes among women with sys ... Full text Link to item Cite

Evaluating Provider Perceptions of Telehealth Utility in Outpatient Rheumatology Telehealth Encounters.

Journal Article J Clin Rheumatol · March 1, 2024 OBJECTIVE: This study aims to explore the factors associated with rheumatology providers' perceptions of telehealth utility in real-world telehealth encounters. METHODS: From September 14, 2020 to January 31, 2021, 6 providers at an academic medical center ... Full text Link to item Cite

The Type 1 & 2 systemic lupus erythematosus model: Perspectives of people living with systemic lupus erythematosus.

Journal Article Lupus · March 2024 OBJECTIVE: In the new Type 1 & 2 model for systemic lupus erythematosus (SLE), Type 1 SLE represents classic inflammatory manifestations, such as arthritis, while Type 2 SLE encompasses symptoms such as pain and fatigue where the relationship to inflammati ... Full text Link to item Cite

Mycophenolate mofetil withdrawal in patients with systemic lupus erythematosus: a multicentre, open-label, randomised controlled trial

Journal Article The Lancet Rheumatology · March 1, 2024 Background: Mycophenolate mofetil is an immunosuppressant commonly used to treat systemic lupus erythematosus (SLE) and lupus nephritis. It is a known teratogen associated with significant toxicities, including an increased risk of infections and malignanc ... Full text Cite

A qualitative study of facilitators of medication adherence in systemic lupus erythematosus: Perspectives from rheumatology providers/staff and patients.

Journal Article Lupus · February 2024 OBJECTIVE: Systemic lupus erythematosus (SLE) disproportionately affects patients from racial and ethnic minority groups. Medication adherence is lower among these patient populations, and nonadherence is associated with worse health outcomes. We aimed to ... Full text Open Access Link to item Cite

Implications of the accuracy of diagnostic algorithms for systemic lupus on our understanding of racial disparities in pregnancy outcomes.

Journal Article Rheumatology (Oxford) · January 4, 2024 OBJECTIVE: Disparities in pregnancy outcomes among women with SLE remain understudied, with few available racially diverse datasets. We sought to identify disparities between Black and White women in pregnancy outcomes within academic institutions in the U ... Full text Link to item Cite

Azathioprine metabolite levels and outcomes during pregnancies with rheumatic disease.

Journal Article Lupus Sci Med · January 3, 2024 OBJECTIVE: Despite widespread use of azathioprine (AZA) during pregnancy, no studies evaluated the impact of pregnancy on AZA metabolites 6-thioguanine nucleotide (6-TGN) and 6-methylmercaptopurine nucleotide (6-MMPN) disposition in rheumatic diseases. Thi ... Full text Link to item Cite

Encounter Appropriateness Score for You Model: Development and Pilot Implementation of a Predictive Model to Identify Visits Appropriate for Telehealth in Rheumatology.

Journal Article Arthritis Care Res (Hoboken) · January 2024 OBJECTIVE: We aimed to develop a decision-making tool to predict telehealth appropriateness for future rheumatology visits and expand telehealth care access. METHODS: The model was developed using the Encounter Appropriateness Score for You (EASY) and elec ... Full text Link to item Cite

Using PROMIS-29 to determine symptom burdens in the context of the Type 1 and 2 systemic lupus erythematosus (SLE) model: a cross sectional study.

Journal Article J Patient Rep Outcomes · December 21, 2023 OBJECTIVE: To account for heterogeneity in systemic lupus erythematosus (SLE) and bridge discrepancies between patient- and physician-perceived SLE activity, we developed the Type 1 and 2 SLE model. We examined PROMIS-29 scores, a composite patient-reporte ... Full text Link to item Cite

Development and psychometric evaluation of a physician global assessment for type 2 systemic lupus erythematosus symptoms.

Journal Article Lupus Sci Med · December 17, 2023 OBJECTIVE: Manifestations of SLE can be categorised as type 1 (classic signs and symptoms of SLE) or type 2 (fatigue, widespread pain and brain fog with an unclear relationship to inflammation). While measures of type 1 SLE activity exist, most current phy ... Full text Link to item Cite

The impact of pregnancy planning and medical readiness on reproductive outcomes in women with systemic lupus erythematosus.

Journal Article Lupus · December 2023 Women with systemic lupus erythematosus (SLE) who get pregnant while SLE is active or while on teratogens have higher risk of poor pregnancy outcomes. The American College of Rheumatology (ACR) Reproductive Health Guidelines recommend women conceive when S ... Full text Link to item Cite

Hospital Admissions and Mortality in Patients With Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis.

Journal Article J Clin Rheumatol · September 1, 2023 BACKGROUND/OBJECTIVES: Anti-neutrophil cytoplasmic antibody-associated vasculitis has reported hospital mortality rates ranging between 10% and 20% with inadequate information regarding causes and outcomes of these hospitalizations. Characterization of out ... Full text Link to item Cite

Using pooled electronic health records data to conduct pharmacoepidemiology safety studies: Challenges and lessons learned.

Journal Article Pharmacoepidemiol Drug Saf · September 2023 PURPOSE: We assessed the suitability of pooled electronic health record (EHR) data from clinical research networks (CRNs) of the patient-centered outcomes research network to conduct studies of the association between tumor necrosis factor inhibitors (TNFi ... Full text Link to item Cite

Vasculitis and Pregnancy: Disease State and Management.

Journal Article Rheum Dis Clin North Am · August 2023 Family planning in women with vasculitis requires an interdisciplinary approach. This article summarizes recommendations and guidance for each phase of family planning in persons with vasculitis including preconception counseling, birth control, pregnancy, ... Full text Link to item Cite

The SPROUT study: A survey on current management practice of reproductive aspects in women of childbearing age with systemic autoimmune rheumatic diseases.

Journal Article Autoimmun Rev · August 2023 The SPROUT (Survey on reproduction in RheUmaTology) study explored current practice in women of childbearing age with systemic autoimmune rheumatic diseases, investigating the counselling on contraception, the prescription of low dose acetylsalicylic acid ... Full text Link to item Cite

Bringing Reproductive Health Guidelines Into Fellowship Training: A National Survey of Adult and Pediatric Rheumatology Fellows and Program Directors.

Journal Article Arthritis Care Res (Hoboken) · July 24, 2023 OBJECTIVE: This study seeks to assess rheumatology fellows' (RFs') and program directors' (PDs') interests in different educational tools and methods and to facilitate curriculum development for reproductive health related to rheumatic disease. METHODS: Co ... Full text Link to item Cite

Pregnancy Outcomes in Patients With Interstitial Lung Disease.

Conference Arthritis Care Res (Hoboken) · May 2023 OBJECTIVE: Women with interstitial lung disease (ILD) are recommended to avoid pregnancy based on limited data. This study seeks to determine maternal and pregnancy outcomes in the largest-to-date cohort of patients with ILD. METHODS: Medical records in th ... Full text Link to item Cite

Obstetric outcomes in women with rheumatic disease and COVID-19 in the context of vaccination status.

Journal Article Rheumatology (Oxford, England) · April 2023 ObjectiveTo describe obstetric outcomes based on COVID-19 vaccination status, in women with rheumatic and musculoskeletal diseases (RMDs) who developed COVID-19 during pregnancy.MethodsData regarding pregnant women entered into the COVID- ... Full text Cite

Frequency of Contraception Documentation in Women With Systemic Lupus Erythematosus and Rheumatoid Arthritis Within the Rheumatology Informatics System for Effectiveness Registry.

Journal Article Arthritis Care Res (Hoboken) · March 2023 OBJECTIVE: We sought to understand the frequency of contraception documentation for women with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) in a large US electronic health record (EHR)-based registry and to identify disparities by terat ... Full text Link to item Cite

Pilot Intervention to Improve Medication Adherence Among Patients With Systemic Lupus Erythematosus Using Pharmacy Refill Data.

Journal Article Arthritis Care Res (Hoboken) · March 2023 OBJECTIVE: Despite high rates of medication nonadherence among patients with systemic lupus erythematosus (SLE), effective interventions to improve adherence in SLE are limited. We aimed to assess the feasibility of a pilot intervention and explore its eff ... Full text Open Access Link to item Cite

Immunology of pregnancy and reproductive health in autoimmune rheumatic diseases. Update from the 11th International Conference on Reproduction, Pregnancy and Rheumatic Diseases.

Journal Article Autoimmun Rev · March 2023 Autoimmune rheumatic diseases (ARD) can affect women and men during fertile age, therefore reproductive health is a priority issue in rheumatology. Many topics need to be considered during preconception counselling: fertility, the impact of disease-related ... Full text Link to item Cite

Belimumab use during pregnancy: a summary of birth defects and pregnancy loss from belimumab clinical trials, a pregnancy registry and postmarketing reports.

Journal Article Ann Rheum Dis · February 2023 OBJECTIVE: Describe available data on birth defects and pregnancy loss in women with systemic lupus erythematosus (SLE) exposed to belimumab. METHODS: Data collected from belimumab clinical trials, the Belimumab Pregnancy Registry (BPR), and postmarketing/ ... Full text Link to item Cite

How to Provide Sexual and Reproductive Health Care to Patients: Focus Groups With Rheumatologists and Rheumatology Advanced Practice Providers.

Journal Article J Rheumatol · February 2023 OBJECTIVE: Rheumatologists have identified challenges to providing sexual and reproductive health (SRH) care to patients with gestational capacity. We conducted focus groups with rheumatologists and rheumatology advanced practice providers (APPs) to elicit ... Full text Link to item Cite

Association of Hurried Communication and Low Patient Self-Efficacy With Persistent Nonadherence to Lupus Medications.

Conference Arthritis Care Res (Hoboken) · January 2023 OBJECTIVE: Medication nonadherence is common among patients with systemic lupus erythematosus (SLE), and adherence often fluctuates with time. Underrepresented racial minorities have disproportionately lower rates of medication adherence and more severe SL ... Full text Link to item Cite

Molecular endotypes of type 1 and type 2 SLE.

Journal Article Lupus Sci Med · January 2023 OBJECTIVE: To character the molecular landscape of patients with type 1 and type 2 SLE by analysing gene expression profiles from peripheral blood. METHODS: Full transcriptomic RNA sequencing was carried out on whole blood samples from 18 subjects with SLE ... Full text Link to item Cite

Reproductive Health in the Rheumatic Diseases

Chapter · January 1, 2023 • Few conditions in rheumatology are fraught with greater concern and more unknowns than those of patients’ fertility and pregnancy. • Understanding the physiology of normal pregnancies is essential to interpreting data from patients with rheumatic disease ... Full text Cite

A comprehensive guide for managing the reproductive health of patients with vasculitis.

Journal Article Nat Rev Rheumatol · December 2022 Vasculitides and their therapies affect all areas of the reproductive life cycle. The ACR, EULAR and the Drugs and Lactation database offer guidance on the management of the reproductive health of patients with rheumatic diseases; however, these guidelines ... Full text Link to item Cite

Development and Initial Validation of a Systemic Lupus Erythematosus-Specific Measure of the Extent of and Reasons for Medication Nonadherence.

Journal Article J Rheumatol · December 2022 OBJECTIVE: Medication nonadherence is common in patients with systemic lupus erythematosus (SLE) and negatively affects outcomes. To better recognize and address nonadherence in this population, there is a need for an easily implementable tool with interpr ... Full text Link to item Cite

Pregnancy Outcomes in Undifferentiated Connective Tissue Disease Compared to Systemic Lupus Erythematosus: A Single Academic Center's Experience.

Journal Article Arthritis Care Res (Hoboken) · October 2022 OBJECTIVE: Systemic lupus erythematosus (SLE) patients have more pregnancy complications than healthy patients. Data regarding pregnancy outcomes in women with undifferentiated connective tissue disease (UCTD) are more limited, and existing studies are con ... Full text Link to item Cite

Telehealth Made EASY: Understanding Provider Perceptions of Telehealth Appropriateness in Outpatient Rheumatology Encounters.

Journal Article ACR Open Rheumatol · October 2022 OBJECTIVE: The purpose of this study was to evaluate a novel scoring system, the Encounter Appropriateness Score for You (EASY), to assess provider perceptions of telehealth appropriateness in rheumatology encounters. METHODS: The EASY scoring system promp ... Full text Open Access Link to item Cite

The association of lupus nephritis with adverse pregnancy outcomes among women with lupus in North America.

Journal Article Lupus · October 2022 OBJECTIVES: We evaluated the association of lupus nephritis (LN) and adverse pregnancy outcomes in prospective cohorts of pregnant women with SLE (systemic lupus erythematosus). METHODS: We conducted a patient-level pooled analysis of data from three cohor ... Full text Link to item Cite

Barriers to Taking Medications for Systemic Lupus Erythematosus: A Qualitative Study of Racial Minority Patients, Lupus Providers, and Clinic Staff.

Journal Article Arthritis Care Res (Hoboken) · September 2022 OBJECTIVE: Underrepresented racial and ethnic minorities are disproportionately affected by systemic lupus erythematosus (SLE). Racial and ethnic minorities also have more severe SLE manifestations that require use of immunosuppressive medications, and oft ... Full text Open Access Link to item Cite

Intermittent and Persistent Type 2 lupus: patient perspectives on two distinct patterns of Type 2 SLE symptoms.

Journal Article Lupus Sci Med · August 2022 OBJECTIVE: We have developed a new conceptual model to characterise the signs and symptoms of SLE: the Type 1 and 2 SLE Model. Within the original model, Type 1 SLE consists of inflammatory manifestations like arthritis, nephritis and rashes; Type 2 SLE in ... Full text Link to item Cite

Association of Health Literacy and Numeracy With Lupus Knowledge and the Creation of the Lupus Knowledge Assessment Test.

Journal Article J Rheumatol · June 2022 OBJECTIVE: Limited health literacy and numeracy are associated with worse patient-reported outcomes and higher disease activity in systemic lupus erythematosus (SLE), but which factors may mediate this association is unknown. We sought to determine the ass ... Full text Link to item Cite

Developing and Validating Methods to Assemble Systemic Lupus Erythematosus Births in the Electronic Health Record.

Journal Article Arthritis Care Res (Hoboken) · May 2022 OBJECTIVE: Electronic health records (EHRs) represent powerful tools to study rare diseases. Our objective was to develop and validate EHR algorithms to identify systemic lupus erythematosus (SLE) births across centers. METHODS: We developed algorithms in ... Full text Link to item Cite

The use of patient-reported outcome measures to classify type 1 and 2 systemic lupus erythematosus activity.

Journal Article Lupus · May 2022 OBJECTIVE: We developed a model that categorizes systemic lupus erythematosus (SLE) activity into two dimensions: Type 1 SLE consists of inflammatory activity, including arthritis, nephritis, and rashes; Type 2 SLE includes fatigue, myalgia, mood disturban ... Full text Link to item Cite

Hydroxychloroquine in the pregnancies of women with lupus: a meta-analysis of individual participant data.

Journal Article Lupus Sci Med · March 2022 OBJECTIVE: Multiple guidelines recommend continuing hydroxychloroquine (HCQ) for SLE during pregnancy based on observational data. The goal of this individual patient data meta-analysis was to identify the potential benefits and harms of HCQ use within lup ... Full text Link to item Cite

COVID-19 in Pregnant Women With Rheumatic Disease: Data From the COVID-19 Global Rheumatology Alliance.

Conference J Rheumatol · January 2022 OBJECTIVE: To describe coronavirus disease 2019 (COVID-19) and pregnancy outcomes in patients with rheumatic disease who were pregnant at the time of infection. METHODS: Since March 2020, the COVID-19 Global Rheumatology Alliance has collected cases of pat ... Full text Link to item Cite

Hydroxychloroquine PK and exposure-response in pregnancies with lupus: the importance of adherence for neonatal outcomes.

Journal Article Lupus Sci Med · January 2022 OBJECTIVE: Evaluate the impact of pregnancy physiology and medication non-adherence on serum hydroxychloroquine (HCQ) pharmacokinetics (PK) and exposure-response in SLE. METHODS: We conducted a PK analysis using data from two observational pregnancy regist ... Full text Link to item Cite

A glimpse into the future of systemic lupus erythematosus.

Journal Article Ther Adv Musculoskelet Dis · 2022 This viewpoint article on a forecast of clinically meaningful changes in the management of systemic lupus erythematosus (SLE) in the next 10 years is based on a review of the current state of the art. The groundwork has been laid by a robust series of clas ... Full text Link to item Cite

Pharmacovigilance pregnancy data in a large population of patients with chronic inflammatory disease exposed to certolizumab pegol.

Journal Article Ther Adv Musculoskelet Dis · 2022 INTRODUCTION: Chronic inflammatory diseases (CIDs), including rheumatic diseases and other inflammatory conditions, often affect women of reproductive age. Tumor necrosis factor inhibitors (TNFi) are widely used to treat CID, but there is limited informati ... Full text Link to item Cite

The importance of weight stabilization amongst those with overweight or obesity: Results from a large health care system.

Journal Article Prev Med Rep · December 2021 Data on patterns of weight change among adults with overweight or obesity are minimal. We aimed to examine patterns of weight change and associated hospitalizations in a large health system, and to develop a model to predict 2-year significant weight gain. ... Full text Link to item Cite

Optimizing reproductive health management in lupus and Sjogren's syndrome.

Journal Article Curr Opin Rheumatol · November 1, 2021 PURPOSE OF REVIEW: People with childbearing capacity who are diagnosed with systemic lupus erythematosus (SLE) and Sjogren's syndrome (SS) have specific and important reproductive health considerations. RECENT FINDINGS: Recommendations from the European Le ... Full text Link to item Cite

Exploring the Preferences of Women Regarding Sexual and Reproductive Health Care in the Context of Rheumatology: A Qualitative Study.

Journal Article Arthritis Care Res (Hoboken) · August 2021 OBJECTIVE: To explore the sexual and reproductive health (SRH) care and counseling needs of young women with rheumatic diseases in the context of their rheumatology care. METHODS: Semistructured qualitative telephone interviews were conducted with female p ... Full text Link to item Cite

Racial Differences in Patient-provider Communication, Patient Self-efficacy, and Their Associations With Systemic Lupus Erythematosus-related Damage: A Cross-sectional Survey.

Journal Article J Rheumatol · July 2021 OBJECTIVE: Despite significant racial disparities in systemic lupus erythematosus (SLE) outcomes, few studies have examined how disparities may be perpetuated in clinical encounters. We aimed to explore associations between areas of clinical encounters - p ... Full text Open Access Link to item Cite

Tough Choices: Exploring Medication Decision-Making During Pregnancy and Lactation Among Women With Inflammatory Arthritis.

Journal Article ACR Open Rheumatol · July 2021 OBJECTIVE: This study explored how women's beliefs about drug safety and interactions with their health care providers influenced their decisions to continue arthritis medications during pregnancy and lactation. METHODS: We collaborated with ArthritisPower ... Full text Link to item Cite

The Categorization of Pain in Systemic Lupus Erythematosus.

Journal Article Rheum Dis Clin North Am · May 2021 Systemic lupus erythematous is a systemic autoimmune disease that can cause severe pain and impair quality of life. Pain in lupus can arise from a variety of mechanisms and is usually assessed in terms of activity and damage. In contrast, categorization of ... Full text Link to item Cite

The importance of pregnancy planning in lupus pregnancies.

Journal Article Lupus · April 2021 OBJECTIVE: In seeking new approaches to improve lupus pregnancy outcomes, we study the association between pregnancy planning, behaviors recommended by American College of Rheumatology's Reproductive Health Guideline 2020, and pregnancy and infant outcomes ... Full text Link to item Cite

Breastfeeding in women with rheumatic diseases.

Journal Article Lupus Sci Med · April 2021 OBJECTIVE: Many rheumatologists and women with rheumatic disease worry that the disease or treatment will prevent breast feeding. International guidelines establish, however, that most antirheumatic medications are compatible with breast feeding. We sought ... Full text Link to item Cite

Using Clinical Characteristics and Patient-Reported Outcome Measures to Categorize Systemic Lupus Erythematosus Subtypes.

Journal Article Arthritis Care Res (Hoboken) · March 2021 OBJECTIVE: The type 1 and type 2 systemic lupus erythematosus (SLE) categorization system was recently proposed to validate the patients' perspective of disease and to capture a more comprehensive spectrum of symptoms. The objective of this study was to ch ... Full text Link to item Cite

Low health numeracy is associated with higher disease activity in systemic lupus erythematosus.

Journal Article Lupus · March 2021 OBJECTIVE: Evidence suggests low health literacy is prevalent in the United States and associated with worse clinical outcomes, yet few studies have investigated health literacy in systemic lupus erythematosus (SLE). The objective of this study was to dete ... Full text Link to item Cite

Impact of the COVID-19 pandemic on patterns of outpatient cardiovascular care.

Journal Article Am Heart J · January 2021 BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic brought about abrupt changes in the way health care is delivered, and the impact of transitioning outpatient clinic visits to telehealth visits on processes of care and outcomes is unclear. METHO ... Full text Link to item Cite

Reproductive health

Chapter · January 1, 2021 Because of the young age at onset and preponderance in women, many patients with systemic lupus erythematosus (SLE) will need specialized management of their reproductive health. While most women with SLE can successfully bear children, the potential hazar ... Full text Cite

Investigating Health Literacy in Systemic Lupus Erythematosus: a Descriptive Review.

Journal Article Curr Allergy Asthma Rep · November 12, 2020 PURPOSE OF REVIEW: Inadequate health literacy is common among American adults, but little is known about the impact of health literacy in rheumatic diseases. The purpose of this article is to review studies investigating health literacy and its association ... Full text Link to item Cite

Dr. Balevic, et al reply.

Journal Article J Rheumatol · October 1, 2020 Full text Link to item Cite

Reproductive health needs of adolescent and young adult women with pediatric rheumatic diseases.

Journal Article Pediatr Rheumatol Online J · August 17, 2020 BACKGROUND: The purpose of this study was to identify reproductive health knowledge gaps and topics that concern adolescent and young adult (AYA) women with pediatric rheumatic diseases and their parents. METHODS: Data collection occurred in two cohorts. I ... Full text Link to item Cite

Racial Disparities in Medication Adherence between African American and Caucasian Patients With Systemic Lupus Erythematosus and Their Associated Factors.

Journal Article ACR Open Rheumatol · July 2020 OBJECTIVE: Medication nonadherence is more common in African Americans compared with Caucasians. We examined the racial adherence gaps among patients with systemic lupus erythematosus (SLE) and explored factors associated with nonadherence. METHODS: Cross- ... Full text Open Access Link to item Cite

Pregnancy outcomes, fertility, and family planning in women with psoriatic arthritis.

Journal Article Obstet Med · June 2020 OBJECTIVE: To quantify pregnancy outcomes and the frequency and cause of infertility among women with psoriatic arthritis. METHODS: Women with psoriatic arthritis aged 20-50 years completed a questionnaire about prior pregnancies, infertility, and family p ... Full text Link to item Cite

Impact of a Multifaceted Educational Program to Improve Provider Skills for Lupus Pregnancy Planning and Management: A Mixed-Methods Approach.

Journal Article ACR Open Rheumatol · June 2020 OBJECTIVE: To bring recent advances in pregnancy management in lupus to women nationwide, this multidimensional educational intervention sought to equip community rheumatologists with the needed skills, attitudes, and confidence to manage contraceptive dec ... Full text Open Access Link to item Cite

Hydroxychloroquine in Patients with Rheumatic Disease Complicated by COVID-19: Clarifying Target Exposures and the Need for Clinical Trials.

Journal Article J Rheumatol · May 11, 2020 OBJECTIVE: To characterize hydroxychloroquine (HCQ) exposure in patients with rheumatic disease receiving longterm HCQ compared to target concentrations with reported antiviral activity against the coronavirus disease 2019 caused by SARS-CoV-2 (COVID-19). ... Full text Link to item Cite

Antirheumatic medications in pregnancy and breastfeeding.

Journal Article Curr Opin Rheumatol · May 2020 PURPOSE OF REVIEW: As active rheumatic and musculoskeletal disease during pregnancy increases the risk for pregnancy loss, preterm birth, and maternal illness, ongoing management with pregnancy-compatible medications can improve these outcomes. Selecting a ... Full text Link to item Cite

2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases.

Journal Article Arthritis Care Res (Hoboken) · April 2020 OBJECTIVE: To develop an evidence-based guideline on contraception, assisted reproductive technologies (ART), fertility preservation with gonadotoxic therapy, use of menopausal hormone replacement therapy (HRT), pregnancy assessment and management, and med ... Full text Link to item Cite

2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases.

Journal Article Arthritis Rheumatol · April 2020 OBJECTIVE: To develop an evidence-based guideline on contraception, assisted reproductive technologies (ART), fertility preservation with gonadotoxic therapy, use of menopausal hormone replacement therapy (HRT), pregnancy assessment and management, and med ... Full text Link to item Cite

Perspectives of Adult Rheumatologists Regarding Family Planning Counseling and Care: A Qualitative Study.

Journal Article Arthritis Care Res (Hoboken) · March 2020 OBJECTIVE: Little is known about whether and how rheumatologists provide family planning counseling and reproductive health care (FPCC) to reproductive-age women with rheumatic diseases. This qualitative study sought to assess rheumatologists' perspectives ... Full text Link to item Cite

Effect of aspirin response signature gene expression on preterm birth and preeclampsia among women with lupus: a pilot study.

Journal Article Lupus · December 2019 BACKGROUND: Women with lupus have an increased risk of preeclampsia and preterm birth, and aspirin 81 mg/day is recommended as a preventative measure for preeclampsia. This pilot study quantified the association between a 60-gene aspirin response signature ... Full text Link to item Cite

Contraception Use Among Reproductive-Age Women With Rheumatic Diseases.

Journal Article Arthritis Care Res (Hoboken) · August 2019 OBJECTIVE: To determine contraception use among a cohort of reproductive-age women (ages 18-50 years) with rheumatic diseases. METHODS: We conducted a study of administrative data from a single, large medical center between the years 2013 and 2014. Women w ... Full text Link to item Cite

Fertility and Ovarian Reserve among Women with Rheumatoid Arthritis.

Journal Article J Rheumatol · May 2019 OBJECTIVE: We sought to identify causes for infertility in women with and without rheumatoid arthritis (RA). METHODS: Women with RA were matched to healthy controls. Differences in anti-Müllerian hormone (AMH) and anovulation were analyzed. RESULTS: Women ... Full text Link to item Cite

Pharmacokinetics of Hydroxychloroquine in Pregnancies with Rheumatic Diseases.

Journal Article Clin Pharmacokinet · April 2019 BACKGROUND: Hydroxychloroquine is an oral drug prescribed to pregnant women with rheumatic disease to reduce disease activity and prevent flares. Physiologic changes during pregnancy may substantially alter drug pharmacokinetics. However, the effect of pre ... Full text Link to item Cite

Contraception methods used by women with rheumatoid arthritis and psoriatic arthritis.

Journal Article Clin Rheumatol · April 2019 Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are common in women of childbearing age and are often treated with teratogenic medications. In this study, we assessed contraceptive methods in young women with RA or PsA and correlated contraceptive ... Full text Link to item Cite

Pregnancy, Periods, and "The Pill": Exploring the Reproductive Experiences of Women with Inflammatory Arthritis.

Journal Article ACR Open Rheumatol · April 2019 OBJECTIVE: Women with inflammatory arthritis appear to have fewer children as compared with healthy women, but few studies have assessed how patients' attitudes and decision making influence their family sizes. Little is also known about how patients exper ... Full text Link to item Cite

Patient-Reported Disease Activity and Adverse Pregnancy Outcomes in Systemic Lupus Erythematosus and Rheumatoid Arthritis.

Conference Arthritis Care Res (Hoboken) · March 2019 OBJECTIVE: While increased rheumatic disease activity during pregnancy has been associated with adverse pregnancy outcomes, this disease activity is typically assessed by physicians. Little is known, however, about the association between patient-reported ... Full text Link to item Cite

Preconceptional Cardiovascular Health and Pregnancy Outcomes in Women with Systemic Lupus Erythematosus.

Journal Article J Rheumatol · January 2019 OBJECTIVE: To estimate the effects of preconceptional cardiovascular (CV) health, measured by American Heart Association (AHA) guidelines, on pregnancy outcomes in women with systemic lupus erythematosus (SLE). METHODS: The study included patients in the H ... Full text Link to item Cite

Hydroxychloroquine Levels throughout Pregnancies Complicated by Rheumatic Disease: Implications for Maternal and Neonatal Outcomes.

Journal Article J Rheumatol · January 2019 OBJECTIVE: Pregnancies in women with active rheumatic disease often result in poor neonatal outcomes. Hydroxychloroquine (HCQ) reduces disease activity and flares; however, pregnancy causes significant physiologic changes that may alter HCQ levels and lead ... Full text Link to item Cite

Provider perceptions on the management of lupus during pregnancy: barriers to improved care.

Journal Article Lupus · January 2019 BACKGROUND: More than half of pregnancies in women with systemic lupus erythematosus (lupus) result in adverse outcomes for the mother or the fetus. We sought to identify aspects of current rheumatologic care that could be improved to decrease the frequenc ... Full text Link to item Cite

Development of ReproKnow, a reproductive knowledge assessment for women with rheumatic diseases.

Journal Article BMC Rheumatol · 2019 BACKGROUND: The objective of this study was to develop an assessment tool, ReproKnow, to evaluate the reproductive health knowledge of women with a wide range of rheumatic diseases. METHODS: The 10-item multiple-choice questionnaire was developed with feed ... Full text Link to item Cite

Rheumatologists' knowledge of contraception, teratogens, and pregnancy risks.

Journal Article Obstet Med · December 2018 INTRODUCTION: Rheumatologists are essential partners in planning and managing pregnancies in women with lupus. Whether they know the essentials of contraceptive and medical treatment in pregnancy, however, is unknown. METHOD: Anonymous in-lecture surveys w ... Full text Link to item Cite

Outcomes of Pregnancies With Maternal/Paternal Exposure in the Tofacitinib Safety Databases for Ulcerative Colitis.

Journal Article Inflamm Bowel Dis · November 29, 2018 BACKGROUND: Active inflammatory bowel disease increases the risk of adverse pregnancy outcomes. Tofacitinib is an oral, small molecule Janus kinase inhibitor for the treatment of ulcerative colitis (UC). As a small molecule, tofacitinib is likely to cross ... Full text Link to item Cite

Pregnancy Outcomes After Exposure to Certolizumab Pegol: Updated Results From a Pharmacovigilance Safety Database.

Journal Article Arthritis Rheumatol · September 2018 OBJECTIVE: Anti-tumor necrosis factor (anti-TNF) medications are effective in controlling chronic inflammatory diseases, but information about their use and safety in pregnancy is limited. Consequently, anti-TNF agents are often discontinued early in gesta ... Full text Link to item Cite

A Comparison of RADAI5 and RAPID3 Disease Measures

Conference ARTHRITIS & RHEUMATOLOGY · September 1, 2018 Link to item Cite

Pregnancy Outcomes Among Women with Rare Autoimmune Diseases

Conference ARTHRITIS & RHEUMATOLOGY · September 1, 2018 Link to item Cite

The prevention, screening and treatment of congenital heart block from neonatal lupus: a survey of provider practices.

Conference Rheumatology (Oxford) · July 1, 2018 OBJECTIVE: To survey an international sample of providers to determine their current practices for the prevention, screening, and treatment of congenital heart block (CHB) due to maternal Ro/SSA antibodies. METHODS: A survey was designed by the organizing ... Full text Link to item Cite

Power in numbers.

Journal Article Rheumatology (Oxford) · July 1, 2018 Collecting useful data on a sufficiently large cohort of pregnancies in women with rheumatic disease is a challenge. The original manuscripts that demonstrated the dangers of pregnancy in women with lupus were relatively small case series. As larger prospe ... Full text Link to item Cite

The new FDA labeling rule: impact on prescribing rheumatological medications during pregnancy.

Journal Article Rheumatology (Oxford) · July 1, 2018 After several decades of deliberation, the US Food and Drug Administration updated the Pregnancy and Lactation Labeling Rule in 2015, eliminating the prior A, B, C, D, X grading system for medication use in pregnancy. Although physicians and patients liked ... Full text Link to item Cite

Introduction

Journal Article Rheumatology (United Kingdom) · July 1, 2018 Full text Cite

Effect of pregnancy on disease flares in patients with systemic lupus erythematosus.

Conference Ann Rheum Dis · June 2018 OBJECTIVE: Prior studies found conflicting results about whether lupus is likely to flare during or after pregnancy. Using a large cohort of pregnant and non-pregnant women with lupus, we estimated the effect of pregnancy on disease flares in systemic lupu ... Full text Link to item Cite

Use of Administrative Databases to Assess Reproductive Health Issues in Rheumatic Diseases.

Journal Article Rheum Dis Clin North Am · May 2018 Administrative databases, registers, and other sources of big data can be interesting sources to address important research questions on reproduction in women with rheumatic diseases. There are many different types of administrative datasets worldwide, and ... Full text Link to item Cite

The impact of menopause on functional status in women with rheumatoid arthritis.

Journal Article Rheumatology (Oxford) · May 1, 2018 OBJECTIVE: The aim of this study was to investigate the association of menopause with functional status outcomes in women with RA. METHODS: Participants were women in a US-wide observational cohort who developed RA before menopause. The HAQ measured functi ... Full text Link to item Cite

Patterns of prednisone use during pregnancy in women with rheumatoid arthritis: Daily and cumulative dose.

Journal Article Pharmacoepidemiol Drug Saf · April 2018 PURPOSE: To characterize prednisone use in pregnant women with rheumatoid arthritis using individual-level heat-maps and clustering individual trajectories of prednisone dose, and to evaluate the association between prednisone dose trajectory groups and ge ... Full text Link to item Cite

Examination of Hydroxychloroquine Use and Hemolytic Anemia in G6PDH-Deficient Patients.

Journal Article Arthritis Care Res (Hoboken) · March 2018 OBJECTIVE: Some sources urge caution when prescribing hydroxychloroquine (HCQ) to patients with G6PDH deficiency, presumably due to a risk of hemolytic anemia. There are limited published data, however, to support this risk. Additionally, not all patients ... Full text Link to item Cite

Reasons for cesarean and medically indicated deliveries in pregnancies in women with systemic lupus erythematosus.

Journal Article Lupus · March 2018 Objective To determine reasons for cesarean and medically indicated deliveries in a registry of pregnant women with SLE compared to RA. Methods Pregnant women with SLE or RA were prospectively followed, and pregnancy outcomes were collected, including whet ... Full text Link to item Cite

Family Planning Counseling for Women With Rheumatic Diseases.

Journal Article Arthritis Care Res (Hoboken) · February 2018 Full text Link to item Cite

Increasing contraception use among women receiving teratogenic medications in a rheumatology clinic.

Journal Article BMJ Open Qual · 2018 Teratogenic medications are often prescribed to women of childbearing age with autoimmune diseases. Literature suggests that appropriate use of contraception among these women is low, potentially resulting in high-risk unintended pregnancies. Preliminary r ... Full text Open Access Link to item Cite

Minimal to no transfer of certolizumab pegol into breast milk: results from CRADLE, a prospective, postmarketing, multicentre, pharmacokinetic study.

Journal Article Ann Rheum Dis · November 2017 BACKGROUND: Women with chronic inflammatory diseases face uncertainty regarding the safety of biologics during breast feeding. CRADLE was the first industry-sponsored study to evaluate certolizumab pegol (CZP) concentrations in human breast milk and estima ... Full text Link to item Cite

Case Study: Lupus in Pregnancy

Conference BIRTH DEFECTS RESEARCH · May 15, 2017 Link to item Cite

Gestational weight gain in women with systemic lupus erythematosus.

Journal Article Lupus · May 2017 Objective The objective of this study was to estimate the proportion of pregnant women with systemic lupus erythematosus meeting Institute of Medicine guidelines for gestational weight gain and determine correlates of adherence to guidelines. Methods Singl ... Full text Link to item Cite

Vasculitis and Pregnancy.

Journal Article Rheum Dis Clin North Am · May 2017 Vasculitis is more often a disease of women beyond their reproductive years, leaving the challenges of pregnancy management difficult to study. Pregnancy complications, including pregnancy loss and preterm birth, are higher among women with all forms of va ... Full text Link to item Cite

Efficacy and Safety of Epratuzumab in Moderately to Severely Active Systemic Lupus Erythematosus: Results From Two Phase III Randomized, Double-Blind, Placebo-Controlled Trials.

Journal Article Arthritis Rheumatol · February 2017 OBJECTIVE: Epratuzumab, a monoclonal antibody that targets CD22, modulates B cell signaling without substantial reductions in the number of B cells. The aim of this study was to report the results of 2 phase III multicenter randomized, double-blind, placeb ... Full text Link to item Cite

Rheumatology Informatics System for Effectiveness: A National Informatics-Enabled Registry for Quality Improvement.

Journal Article Arthritis Care Res (Hoboken) · December 2016 OBJECTIVE: The Rheumatology Informatics System for Effectiveness (RISE) is a national electronic health record (EHR)-enabled registry. RISE passively collects data from EHRs of participating practices, provides advanced quality measurement and data analyti ... Full text Link to item Cite

Racial and Ethnic Disparities in the Pregnancies of Women With Systemic Lupus Erythematosus.

Journal Article Arthritis Care Res (Hoboken) · October 2016 OBJECTIVE: Both systemic lupus erythematosus (SLE; lupus) and pregnancy individually have significant racial disparities, with black women experiencing higher rates of complications, yet no large studies have focused on the impact of race/ethnicity on preg ... Full text Link to item Cite

Infertility in Women with Rheumatoid Arthritis

Conference ARTHRITIS & RHEUMATOLOGY · October 1, 2016 Link to item Cite

Contraceptive Methods in Women with Rheumatoid Arthritis

Conference ARTHRITIS & RHEUMATOLOGY · October 1, 2016 Link to item Cite

Reporting of Sex Effects by Systematic Reviews on Interventions for Depression, Diabetes, and Chronic Pain.

Journal Article Ann Intern Med · August 2, 2016 Systematic reviews (SRs) have the potential to contribute uniquely to the evaluation of sex and gender differences (termed "sex effects"). This article describes the reporting of sex effects by SRs on interventions for depression, type 2 diabetes mellitus, ... Full text Link to item Cite

Breastfeeding in mothers with systemic lupus erythematosus.

Journal Article Lupus · August 2016 INTRODUCTION: Breastfeeding is known to improve the well-being of a mother and her infant, and about half of all new mothers breastfeed, but it is unknown how breastfeeding is pursued in systemic lupus erythematosus (SLE; lupus) patients. We sought to dete ... Full text Link to item Cite

Pregnancy Outcomes in the Tofacitinib Safety Databases for Rheumatoid Arthritis and Psoriasis.

Journal Article Drug Saf · August 2016 INTRODUCTION: Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA), and is being investigated for the treatment of psoriasis. Both conditions can present in women of child-bearing potential, but pregnancy was an excl ... Full text Link to item Cite

Safety, Tolerability, Pharmacokinetic and Pharmacodynamic Properties of SBI-087, a CD20-Directed B-cell Depleting Agent: Phase 1 Dose Escalating Studies in Patients With Either Mild Rheumatoid Arthritis or Systemic Lupus.

Journal Article Clin Ther · June 2016 PURPOSE: SBI-087 is a Small Modular Immunopharmaceutical Protein™(SMIP™) drug that binds to CD20 and has been reported to deplete B cells in murine/primate studies. The safety, tolerability and pharmacokinetic/pharmacodynamic properties of SBI-087 were eva ... Full text Link to item Cite

AB0284 Reproductive Health in Adult Women with JIA and RA

Conference Annals of the Rheumatic Diseases · June 2016 Full text Cite

Long-Term Safety and Efficacy of Epratuzumab in the Treatment of Moderate-to- Severe Systemic Lupus Erythematosus: Results From an Open-Label Extension Study.

Journal Article Arthritis Care Res (Hoboken) · April 2016 OBJECTIVE: The primary objective was to assess the long-term safety of repeated courses of epratuzumab therapy in patients with moderate-to-severe systemic lupus erythematosus. Secondary objectives were to assess long-term efficacy and health-related quali ... Full text Link to item Cite

Pregnancy Outcomes in Subjects Exposed to Certolizumab Pegol.

Journal Article J Rheumatol · December 2015 OBJECTIVE: To provide information on pregnancy outcomes in women receiving certolizumab pegol (CZP). METHODS: The UCB Pharma safety database was searched for pregnancies through to September 1, 2014. Reports for maternal and paternal CZP exposure were incl ... Full text Link to item Cite

Racial Disparities in Lupus Pregnancy

Conference ARTHRITIS & RHEUMATOLOGY · October 1, 2015 Link to item Cite

A Comparison of Pregnancy Outcomes before and after Lupus Diagnosis

Conference ARTHRITIS & RHEUMATOLOGY · October 1, 2015 Link to item Cite

Randomized, Double-Blind, Placebo-Controlled Trial of the Effect of Vitamin D3 on the Interferon Signature in Patients With Systemic Lupus Erythematosus.

Conference Arthritis Rheumatol · July 2015 OBJECTIVE: Vitamin D modulates the immune response and blocks induction of an interferon (IFN) signature by systemic lupus erythematosus (SLE) sera. This study was undertaken to investigate the effects of vitamin D supplementation on the IFN signature in p ... Full text Link to item Cite

State of the art: Reproduction and pregnancy in rheumatic diseases.

Journal Article Autoimmun Rev · May 2015 Throughout the last decade, increasing awareness has been raised on issues related to reproduction in rheumatic diseases including basic research to clarify the important role of estrogens in the etiology and pathophysiology of immune/inflammatory diseases ... Full text Link to item Cite

Breastfeeding Practice in Patients with Systemic Lupus Erythematosus

Journal Article CLINICAL AND EXPERIMENTAL RHEUMATOLOGY · May 1, 2015 Link to item Cite

Fertility and infertility in rheumatoid arthritis.

Journal Article Curr Opin Rheumatol · May 2014 PURPOSE OF REVIEW: Despite decades of evidence suggesting that women with rheumatoid arthritis (RA) have fewer children than their healthy peers, this information is not widely known among clinicians. The causes of decreased fertility in this population ha ... Full text Link to item Cite

An autoreactive antibody from an SLE/HIV-1 individual broadly neutralizes HIV-1.

Journal Article J Clin Invest · April 2014 Broadly HIV-1-neutralizing antibodies (BnAbs) display one or more unusual traits, including a long heavy chain complementarity-determining region 3 (HCDR3), polyreactivity, and high levels of somatic mutations. These shared characteristics suggest that BnA ... Full text Link to item Cite

Systemic lupus erythematosus and pregnancy outcomes: an update and review of the literature.

Journal Article Curr Opin Rheumatol · March 2014 PURPOSE OF REVIEW: This review synthesizes new data from the studies published between 2011 and 2013, with particular focus on the different information gleaned by various study types. RECENT FINDINGS: Population-based cohorts have demonstrated that women ... Full text Link to item Cite

Systemic lupus erthematosus

Journal Article · March 1, 2014 Since systemic lupus erythematosus (SLE) is an autoimmune disease that primarily affects women during their reproductive years, pregnancy is a frequently encountered challenge in women with this disorder. In the past, women with SLE were advised to avoid p ... Full text Cite

Family planning and pregnancy issues for women with systemic inflammatory diseases: patient and physician perspectives.

Journal Article BMJ Open · February 5, 2014 OBJECTIVES: To identify family planning and pregnancy (FPP) issues for female patients of childbearing age living with a chronic inflammatory disease and to assess whether current clinical practice routinely provides adequate support to alleviate these con ... Full text Link to item Cite

Aspirin for prevention of preeclampsia in lupus pregnancy.

Journal Article Autoimmune Dis · 2014 Preeclampsia, the onset of hypertension and proteinuria during pregnancy, is a common medical disorder with high maternal and fetal mortality and morbidity. The underlying pathology remains poorly understood and includes inflammation, endothelial dysfuncti ... Full text Link to item Cite

Family planning and pregnancy issues for women with systemic inflammatory diseases: Patient and physician perspectives

Journal Article BMJ Open · 2014 Objectives: To identify family planning and pregnancy (FPP) issues for female patients of childbearing age living with a chronic inflammatory disease and to assess whether current clinical practice routinely provides adequate support to alleviate these con ... Full text Cite

The Impact Of Menopause In Rheumatoid Arthritis Activity.

Conference ARTHRITIS AND RHEUMATISM · October 1, 2013 Link to item Cite

Predictors of preterm birth in patients with mild systemic lupus erythematosus.

Journal Article Ann Rheum Dis · September 1, 2013 OBJECTIVE: While increased disease activity is the best predictor of preterm birth in women with systemic lupus erythematosus (SLE), even women with low disease activity are at increased risk of this complication. Biomarkers that would identify at-risk pre ... Full text Link to item Cite

Pathogenesis of pregnancy complications in systemic lupus erythematosus.

Journal Article Curr Opin Rheumatol · September 2013 PURPOSE OF REVIEW: In spite of the advances made in the management of pregnancies in women with systemic lupus erythematosus (SLE), maternal complications and adverse fetal outcomes still exceed the rate of pregnancy complications in the general population ... Full text Link to item Cite

Pregnancy outcomes among patients with vasculitis.

Journal Article Arthritis Care Res (Hoboken) · August 2013 OBJECTIVE: Pregnancy outcomes of patients with vasculitis are unknown, but are of great concern to patients and physicians. Through an online survey, this study assessed pregnancy outcomes among patients with vasculitis. METHODS: Participants in the Vascul ... Full text Link to item Cite

Reply: To PMID 22505314.

Journal Article Arthritis Care Res (Hoboken) · July 2013 Full text Link to item Cite

Neonatal Lupus Erythematosus

Journal Article · January 1, 2013 Full text Cite

Pregnancy in Women with SLE

Journal Article · January 1, 2013 Full text Cite

Maternal autoantibody levels in congenital heart block and potential prophylaxis with antiinflammatory agents.

Journal Article Am J Obstet Gynecol · January 2013 OBJECTIVE: The importance of maternal autoantibody levels in congenital heart block and elucidation of maternal factors that may reduce disease burden require further clarification. STUDY DESIGN: Pregnancies complicated by maternal anti-Ro antibodies from ... Full text Link to item Cite

The impact of cyclophosphamide on menstruation and pregnancy in women with rheumatologic disease.

Journal Article Lupus · January 2013 BACKGROUND: While cyclophosphamide (CYC) can save the life of a young woman with severe rheumatologic disease, it may lead to the long-term side-effects of infertility and premature menopause. We compared the reproductive health histories of young women wi ... Full text Link to item Cite

Depressive symptoms and associated factors in systemic lupus erythematosus.

Journal Article Psychosomatics · 2013 BACKGROUND: Depressive symptoms affect anywhere from 11% to 71% of patients with systemic lupus erythematosus (SLE), which may be related to SLE disease activity, other clinical variables, or sociodemographic factors. OBJECTIVE: We aimed to measure the rat ... Full text Link to item Cite

Reply

Journal Article Arthritis Care and Research · November 1, 2012 Full text Cite

Self-efficacy and pain catastrophizing in systemic lupus erythematosus: relationship to pain, stiffness, fatigue, and psychological distress.

Journal Article Arthritis Care Res (Hoboken) · September 2012 OBJECTIVE: To determine how self-efficacy for pain control and pain catastrophizing, both potentially modifiable pain coping cognitions, are related to pain, stiffness, fatigue, and psychological distress in patients with systemic lupus erythematosus (SLE) ... Full text Link to item Cite

Effects of infertility, pregnancy loss, and patient concerns on family size of women with rheumatoid arthritis and systemic lupus erythematosus.

Journal Article Arthritis Care Res (Hoboken) · May 2012 OBJECTIVE: Women with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) have fewer children on average than other women. We sought to determine the roles of infertility, pregnancy loss, and personal choice on family size in women with these ... Full text Link to item Cite

Ovarian reserve diminished by oral cyclophosphamide therapy for granulomatosis with polyangiitis (Wegener's).

Journal Article Arthritis Care Res (Hoboken) · December 2011 OBJECTIVE: Standard treatment for severe granulomatosis with polyangiitis (Wegener's) (GPA) is daily oral cyclophosphamide (CYC), a cytotoxic agent associated with ovarian failure. In this study, we assessed the rate of diminished ovarian reserve in women ... Full text Link to item Cite

Infertility Among Patients with Vasculitis

Conference ARTHRITIS AND RHEUMATISM · October 1, 2011 Link to item Cite

Pregnancy in Men and Women with Vasculitis

Conference ARTHRITIS AND RHEUMATISM · October 1, 2011 Link to item Cite

Contraception Use in Women with Rheumatoid Arthritis.

Conference ARTHRITIS AND RHEUMATISM · October 1, 2011 Link to item Cite

The clinical utility of measuring complement and anti-dsDNA antibodies during pregnancy in patients with systemic lupus erythematosus.

Journal Article J Rheumatol · June 2011 Featured Publication OBJECTIVE: The importance of low complement and anti-dsDNA during pregnancy in patients with systemic lupus erythematosus (SLE) is poorly defined. We investigated the effect of these laboratory tests and clinical SLE activity on pregnancy outcomes. METHODS ... Full text Link to item Cite

Microparticles as antigenic targets of antibodies to DNA and nucleosomes in systemic lupus erythematosus.

Journal Article J Autoimmun · May 2011 Systemic lupus erythematosus is a prototypic autoimmune disease characterized by antibodies to DNA and other nuclear molecules. While these antibodies can form immune complexes, the mechanisms generating the bound nuclear antigens are not known. These stud ... Full text Link to item Cite

Late ovarian hyperstimulation syndrome after controlled ovarian stimulation in a woman with systemic lupus erythematosus and lupus nephritis.

Journal Article Fertil Steril · April 2011 Featured Publication OBJECTIVE: To report a case of late ovarian hyperstimulation syndrome (OHSS) in a woman with lupus nephritis undergoing controlled ovarian stimulation and in vitro fertilization (IVF) with subsequent transfer into a gestational surrogate. DESIGN: A case re ... Full text Link to item Cite

Use of gnrh agonists for prevention of chemotherapy-induced gonadotoxicity

Journal Article · January 1, 2011 The use of gonadotropin-releasing hormone agonists (GnRHa) for prevention of chemotherapy-induced gonadotoxicity remains controversial [1, 2]. Ovarian suppression to prevent oocyte loss during chemotherapy was proposed based upon the observation that non-c ... Full text Cite

The use of anti-TNFα medications for rheumatologic disease in pregnancy.

Journal Article Int J Womens Health · August 9, 2010 Featured Publication Anti-TNFα medications have led to vast improvements in the treatment of inflammatory conditions, including rheumatoid arthritis and Crohn's disease. As these diseases often afflict women in their reproductive years, the safety of these drugs during pregnan ... Full text Link to item Cite

Rheumatologic Disorders in Pregnancy

Journal Article · July 9, 2010 Full text Cite

Managing contraception and pregnancy in the rheumatologic diseases.

Journal Article Best Pract Res Clin Rheumatol · June 2010 Featured Publication Most pregnancies in women with rheumatologic disease will result in the delivery of a healthy baby. Pregnancy can be particularly risky in women with active disease or on teratogenic medications, making contraception an important issue for these women. All ... Full text Link to item Cite

The management of rheumatic diseases in pregnancy.

Journal Article Scand J Rheumatol · March 2010 Featured Publication Pregnancy can create a challenge for physicians caring for women with rheumatic diseases. For many women with rheumatoid arthritis (RA), pregnancy can provide a reprieve from long-term joint pain and inflammation, but others will not experience remission a ... Full text Link to item Cite

Pregnancy in the rheumatic diseases

Journal Article · December 1, 2009 Few conditions in rheumatology are fraught with greater concern and more unknowns than those of fertility and pregnancy. Patients with rheumatologic disease are not at higher risk for infertility than the general population, unless they have received cyclo ... Full text Cite

GnRH: Authors' response

Journal Article Journal of Women's Health · September 1, 2009 Full text Cite

Ovarian preservation by GnRH agonists during chemotherapy: a meta-analysis.

Journal Article J Womens Health (Larchmt) · March 2009 PURPOSE: Treatment with cyclophosphamide (CYC) confers up to a 40% risk of ovarian failure in women of reproductive age. The use of GnRH agonists (GnRHa) to preserve ovarian function has been investigated in several small studies. We performed a systematic ... Full text Link to item Cite

Impact of pregnancy on rheumatoid arthritis activity

Journal Article Future Rheumatology · December 1, 2008 For many women with rheumatoid arthritis (RA), pregnancy is remembered as a time of relative comfort and well-being, with arthritis frequently entering remission. Since the 1930s, it has been recognized that RA abates during pregnancy and flares after deli ... Full text Cite

A national study of the complications of lupus in pregnancy.

Journal Article Am J Obstet Gynecol · August 2008 Featured Publication OBJECTIVE: This study was undertaken to determine the risk of rare complications during pregnancy for women with systemic lupus erythematosus. STUDY DESIGN: By using the Nationwide Inpatient Sample from 2000-2003, we compared maternal and pregnancy complic ... Full text Link to item Cite

Pregnancy

Journal Article · December 1, 2007 Full text Cite

Lupus activity in pregnancy.

Journal Article Rheum Dis Clin North Am · May 2007 Featured Publication Pregnancy in a woman with systemic lupus erythematosus (SLE) can be complicated by both lupus activity and pregnancy mishaps. The majority of recent studies found an increase in lupus activity during pregnancy, perhaps exacerbated by hormonal shifts requir ... Full text Link to item Cite

Hydroxychloroquine in lupus pregnancy.

Journal Article Arthritis Rheum · November 2006 Featured Publication OBJECTIVE: Hydroxychloroquine (HCQ) is often needed to manage disease activity in systemic lupus erythematosus (SLE) during pregnancy. The purpose of this study was to examine lupus activity and pregnancy outcomes in women with SLE treated or not treated w ... Full text Link to item Cite

Risk factors for pregnancy loss in women with lupus

Conference Journal of Reproductive Immunology · October 2006 Full text Cite

National study of medical complications in SLE pregnancies.

Conference ARTHRITIS AND RHEUMATISM · September 1, 2006 Link to item Cite

Early risk factors for pregnancy loss in lupus.

Journal Article Obstet Gynecol · February 2006 Featured Publication OBJECTIVE: To identify early risk factors for pregnancy loss in lupus pregnancies. METHODS: We conducted a cohort study of all pregnancies seen in the first trimester in lupus patients followed from 1987 to 2002 at the Hopkins Lupus Center. At each visit, ... Full text Link to item Cite

Pregnancy and Systemic Lupus Erythematosus

Journal Article Handbook of Systemic Autoimmune Diseases · December 1, 2005 Full text Cite

Azathioprine use in lupus pregnancy.

Conference ARTHRITIS AND RHEUMATISM · September 1, 2005 Link to item Cite

Early risk factors for pregnancy loss in lupus

Conference OBSTETRICS AND GYNECOLOGY · April 1, 2005 Link to item Cite

The impact of increased lupus activity on obstetric outcomes.

Journal Article Arthritis Rheum · February 2005 Featured Publication OBJECTIVE: Systemic lupus erythematosus is associated with multiple adverse pregnancy outcomes. We examined the impact of disease activity on spontaneous abortions, perinatal mortality, preterm delivery, and birth weight. METHODS: The study was designed to ... Full text Link to item Cite

Cyclophosphamide for lupus during pregnancy.

Journal Article Lupus · 2005 Featured Publication Severe systemic lupus erythematosus often requires the use of cyclophosphamide in women of reproductive age. As cyclophosphamide is generally avoided during pregnancy because of its teratogenic risk, its impact on fetal survival is poorly understood. This ... Full text Link to item Cite

Digital necrosis related to carboplatin and gemcitabine therapy in systemic sclerosis.

Journal Article J Rheumatol · June 2003 Featured Publication We present a woman with scleroderma who developed multiple ischemic digits after chemotherapy for lung cancer. The ischemia started during treatment with carboplatin and gemcitabine and required amputation of the affected digits. A review of the literature ... Link to item Cite