Arthritis Rheumatol 2020 Apr
2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases.
Related Questions
Would you consider using transdermal estrogen in a patient with “high risk” APLS patient on warfarin?
Given her clinical diagnosis of high-risk APS, I would first trial nonhormonal therapies or progesterone-only therapies for management of her post-menopausal symptoms. Current ACR guidance recommends against hormone replacement therapy in patients with APS on anticoagulation (Sammaritano et al., PMI...
Do you typically screen patients for antiphospholipid antibodies in autoimmune diseases besides lupus in the absence of a clotting event?
I would check antiphospholipid antibodies (APLAs) in a few situations in the absence of thrombotic events: 1. In someone with other APS manifestations: Obstetrical complications (especially) APL nephropathy noted on renal bx Unexplained adrenal hemorrhage/microthrombosis Non-infectious endocardial v...
How do you counsel patients regarding contraception use while taking mycophenolate/mycophenolic acid?
There are some data that mycophenolate mofetil may decrease the effectiveness of oral contraceptives. In patients who are taking MMF and taking oral contraceptives as their form of contraception, an additional form of contraception is preferred. However, this is not an absolute recommendation. Mycop...
What do you recommend for fertility preservation in pediatric patients with impending cyclophosphamide use for treatment of a rheumatic disease?
Cyclophosphamide (CYC) is an alkylating agent primarily used in the treatment of malignant lymphomas, and its gonadotoxic properties are well-established. CYC can cause ovarian toxicity via follicle atresia and granulosa cell apoptosis in females as well as oligospermia and azoospermia in males. In ...