Abstract:
PURPOSE OF REVIEW:In contrast to the disease remission enjoyed by a majority of rheumatoid arthritis (RA) patients during pregnancy, the immediate postpartum period is generally characterized by flare. Managing symptoms during this time is challenging because the potential transfer of medication into the breast milk of nursing mothers may limit which antirheumatic drugs can be safely used. The benefits of breastfeeding are significant, however, so an understanding of how to adjust medications to permit lactation and nursing is important for rheumatologists. RECENT FINDINGS:Although nonsteroidal antiinflammatory drugs (NSAIDs) in general are passed into milk in low doses, shorter acting NSAIDs are preferred, with caution for premature infants. Prednisone can be taken by nursing mothers, although when used at doses higher than 20 mg/day an interval of 4 h after dosing and prior to breastfeeding is recommended. Hydroxychloroquine and sulfasalazine are compatible with nursing. Cyclosporine is generally allowed in lactating women, although a single infant was reported to develop therapeutic drug levels. Azathioprine (AZA) and tissue necrosis factor-α-inhibitors have little to no transfer into breast milk, with negligible levels measured in infant sera, and thus may be considered for use in lactating mothers. Methotrexate and leflunomide should not be used. Other biological RA medications have not been evaluated, and are, therefore, best avoided by breastfeeding patients. SUMMARY:Many but not all RA medications may be used during lactation with low risk to the nursing infant; this review summarizes the available data for commonly used medications in order to help guide therapy during the postpartum period.
journal_name
Curr Opin Rheumatoljournal_title
Current opinion in rheumatologyauthors
Sammaritano LR,Bermas BLdoi
10.1097/BOR.0000000000000055subject
Has Abstractpub_date
2014-05-01 00:00:00pages
354-60issue
3eissn
1040-8711issn
1531-6963journal_volume
26pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:Systemic sclerosis, or scleroderma, is a systemic autoimmune disease manifest by vascular damage and fibrosis within the skin and visceral organs. Whereas scleroderma is a heterogenous disorder in terms of disease symptoms and clinical course, scleroderma-specific autoantibody profiles associate stron...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/00002281-200311000-00016
更新日期:2003-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Rapid introduction of newly developed drugs in the absence of clear understanding of the pathophysiologic mechanisms behind drug-induced lupus erythematosus (DILE) can sometimes make DILE difficult to recognize in clinical practice. The purpose of this review is to summarize drugs most recently report...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0000000000000522
更新日期:2018-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Cryoglobulinemic vasculitis is an immune-complex-mediated systemic vasculitis involving small-medium-sized vessels. A causative role of hepatitis C virus in over 80% patients has been definitively established, with heterogeneous geographical distribution. This review focuses on recent etiopathogenetic...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/01.bor.0000198002.42826.c2
更新日期:2006-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Systemic lupus erythematosus is characterized by the production of antinuclear autoantibodies and dysfunction of T-cells, B-cells, and dendritic cells. Here, we review newly recognized genetic factors and mechanisms that underlie abnormal intracellular signal processing and intercellular communication...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0b013e32832e977c
更新日期:2009-09-01 00:00:00
abstract:PURPOSE OF REVIEW:The incidence and mortality of cardiovascular disease are increased in the context of rheumatoid arthritis. The purpose of this review is to examine our evolving understanding of the pathogenesis of cardiovascular disease in rheumatoid arthritis and to underscore the importance of tailored prevention ...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/01.bor.0000159924.97019.25
更新日期:2005-05-01 00:00:00
abstract:PURPOSE OF REVIEW:Renal complications are important in scleroderma (systemic sclerosis) and include scleroderma renal crisis. This is a medical emergency that requires careful management. Recent cohort studies have highlighted key aspects of management and outcome and these are reviewed. RECENT FINDINGS:Two recent art...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0b013e3283108df7
更新日期:2008-11-01 00:00:00
abstract::The first part of this article draws together descriptive studies on the direct medical costs of osteoporosis. The second part is devoted to economic evaluation of 1) osteoporosis treatment on the basis of clinical criteria and 2) preventive strategies, some of them including bone mineral density screening. These anal...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/00002281-199807000-00015
更新日期:1998-07-01 00:00:00
abstract:PURPOSE OF REVIEW:It is well recognized that the complement system plays multiple roles in systemic lupus erythematosus. Activation of the classical pathway by immune complexes leads to the generation of inflammatory mediators, thus promoting tissue injury. Complement activation also plays an important role in the main...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/01.bor.0000172799.03379.86
更新日期:2005-09-01 00:00:00
abstract::In the 2 years following menarche, bone mass increases substantially; this is an important new finding concerning peak bone mass. Studies of twins have given significant insights into the effect of heredity on bone mass. Many determinants of bone mass, bone gain, and bone loss thus have been characterized for people o...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/00002281-199405000-00015
更新日期:1994-05-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this study is to review the evidence and recent developments leading to novel therapeutics in scleroderma. RECENT FINDINGS:Recent advances have been made in understanding the key pathogenetic aspects of scleroderma, and these have led to potential targeted therapeutic agents for the ma...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0b013e328337c3d6
更新日期:2010-05-01 00:00:00
abstract::Angiitis of the central nervous system (CNS) remains a poorly understood and clinically challenging form of vascular inflammatory disease. Primary angiitis of the CNS (PACNS) has been viewed as a relentless and uniformly fatal disorder if untreated. In addition, recent trends have demonstrated an increasing reliance o...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:1995-01-01 00:00:00
abstract::There is growing evidence that distinct molecular and cellular interactions in the rheumatoid synovium result in a complex cascade of pathophysiologic events. These interactions finally lead to progressive joint destruction, in a way that is different from all other joint diseases. Keystones are inflammation, prolifer...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/00002281-199605000-00008
更新日期:1996-05-01 00:00:00
abstract::Animal models of systemic connective tissue diseases have provided valuable insights into the causative mechanisms and the pathogenesis of these diseases, and have provided the means to test potentially useful therapeutic interventions. Although numerous animal models for systemic sclerosis (SSc) have been described, ...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/00002281-200211000-00008
更新日期:2002-11-01 00:00:00
abstract::Musculoskeletal problems remain among the main limitations of the quality of life of renal failure patients, in particular of those treated with long-term maintenance dialysis. Renal osteodystrophy continues to receive great attention. The mechanisms of uremic skeletal resistance to parathormone (PTH) are further inve...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/00002281-200301000-00009
更新日期:2003-01-01 00:00:00
abstract:PURPOSE OF REVIEW:To highlight recent evidence regarding the contribution of traditional and nontraditional [e.g. inflammatory markers, rheumatoid arthritis (RA) features] risk factors toward the excess cardiovascular risk in RA. RECENT FINDINGS:The impact of traditional risk factors on the development of cardiovascul...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0b013e32834ff2fd
更新日期:2012-03-01 00:00:00
abstract::Advances in molecular biologic techniques and the availability of novel immunologic reagents have allowed new approaches to understanding the pathogenesis of human autoimmune diseases, including the idiopathic inflammatory myopathies. Indirect evidence that autoreactive T cells mediate muscle inflammation in the human...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/00002281-199511000-00007
更新日期:1995-11-01 00:00:00
abstract::Osteoarthritis is the most common form of arthritis in adults and its incidence increases with age. More than 50% of people aged 65 and older have radiographic changes of knee osteoarthritis. Calcium crystals, including calcium pyrophosphate dihydrate and basic calcium phosphate crystals, are also common in the elderl...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/00002281-200205000-00018
更新日期:2002-05-01 00:00:00
abstract:PURPOSE OF REVIEW:To increase awareness and review the management of chronic viral hepatitis in individuals treated with immune-modifying agents to avoid potentially severe consequences. RECENT FINDINGS:Hepatitis B virus (HBV) reactivation has been reported with a wide variety of immunosuppressive regimens ranging fro...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0000000000000067
更新日期:2014-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Systemic lupus erythematosus (SLE) and Sjogren's syndrome are chronic inflammatory diseases characterized by the dysfunction of T cells, B cells, and dendritic cells and the production of antinuclear autoantibodies. Here, we evaluate newly discovered molecular and cellular targets for the treatment of...
journal_title:Current opinion in rheumatology
pub_type: 社论,评审
doi:10.1097/BOR.0b013e32832efe6b
更新日期:2009-09-01 00:00:00
abstract:PURPOSE OF REVIEW:The aim of this study was to evaluate the relationship between infection with SARS-CoV-2 and autoimmunity. RECENT FINDINGS:Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome (SARS) associated coronavirus 2 (SARS-CoV-2). Although most of the infect...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章
doi:10.1097/BOR.0000000000000776
更新日期:2021-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Exercise was established as an integral part of the nonpharmacological treatment of fibromyalgia approximately 20 years ago. Since then many studies have investigated the effects of exercise-either alone or in combination with other interventions. This review will discuss the benefits of exercise alon...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/00002281-200403000-00012
更新日期:2004-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Since their discovery over 15 years ago, intensive research has focused on the presence, phenotype and function of FOXP3(+) regulatory T cells (Treg) in autoimmune diseases such as rheumatoid arthritis (RA). The questions of whether Treg deficiencies underlie autoimmune pathology and whether or how Tr...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0b013e32835d0ee4
更新日期:2013-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Diffuse idiopathic skeletal hyperostosis (DISH) or Forestier's disease is a common disorder among older adults. The diagnosis is based solely on radiographic abnormalities defined using the Resnick criteria. DISH is characterized by ossification of the anterior longitudinal ligament of the spine and v...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/00002281-200405000-00021
更新日期:2004-05-01 00:00:00
abstract:PURPOSE OF REVIEW:The present review focuses on the most significant recent findings regarding selective estrogen receptor modulators (SERMs) and selective androgen receptor modulators (SARMs). SERMs, which interact with estrogen receptor-alpha and estrogen receptor-beta in multiple tissues, continue to generate clinic...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0b013e32832ca447
更新日期:2009-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Recent developments in the nosology of primary systemic vasculitis are placed in the context of an historical overview. The ongoing attempts to develop criteria for classification and diagnosis are discussed. RECENT FINDINGS:Giant cell arteritis has supplanted temporal arteritis as the preferred term...
journal_title:Current opinion in rheumatology
pub_type: 历史文章,杂志文章,评审
doi:10.1097/BOR.0b013e3280119877
更新日期:2007-01-01 00:00:00
abstract::Epidemiologic studies of rheumatic diseases can be broadly divided into those that describe the occurrence of specific disorders, those that attempt to quantify the role of putative risk factors for disease occurrence, and those that define the outcome and factors associated with it. Studies in this area have tended t...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/00002281-199903000-00002
更新日期:1999-03-01 00:00:00
abstract:PURPOSE OF REVIEW:To review radiographic and MRI developments in measuring osteoarthritis progression in the tibiofemoral compartment of the knee. RECENT FINDINGS:Standardized techniques for measuring joint space width in the medial tibiofemoral compartment, using standardized radiographic protocols, have become accep...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0b013e3283235add
更新日期:2009-03-01 00:00:00
abstract:PURPOSE OF REVIEW:The introduction of checkpoint inhibitors as well as other allied advances in cancer immunology has made immunotherapy a pillar in the treatment of cancer. At the same time, these therapies have been associated with a remarkable array of immune-mediated toxicities observed in virtually every organ sys...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/BOR.0000000000000684
更新日期:2020-03-01 00:00:00
abstract::Refinement of criteria for classifying childhood rheumatic diseases has contributed to earlier, more complete, and more precise diagnosis of children with spondyloarthropathies. Recent additions to the literature have contributed new international perspectives relating to the prevalence of juvenile spondyloarthropathi...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/00002281-200009000-00013
更新日期:2000-09-01 00:00:00
abstract::The molecular mechanisms of the primary immunodeficiencies have been further explored and provide insights into the regulation of the immune response and its role in autoimmune disease, infection, and malignancy. The critical role of CD40-CD40 ligand-mediated effects in T cell-dependent B cell activation, shown throug...
journal_title:Current opinion in rheumatology
pub_type: 杂志文章,评审
doi:10.1097/00002281-199601000-00010
更新日期:1996-01-01 00:00:00