Inflammatory Bowel Disease in Pregnancy Clinical Care Pathway: A Report From the American Gastroenterological Association IBD Parenthood Project Working Group

Gastroenterology, Journal Year: 2019, Volume and Issue: 156(5), P. 1508 - 1524

Published: Jan. 16, 2019

Language: Английский

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Nausea and vomiting of pregnancy and hyperemesis gravidarum

Nature Reviews Disease Primers, Journal Year: 2019, Volume and Issue: 5(1)

Published: Sept. 12, 2019

Language: Английский

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An update on generalized pustular psoriasis

Expert Review of Clinical Immunology, Journal Year: 2019, Volume and Issue: 15(9), P. 907 - 919

Published: Sept. 2, 2019

ABSTRACT Introduction: Generalized pustular psoriasis (GPP) is a rare, severe relapsing/remitting, multisystem disease that can be difficult to treat. Recent clinical, histological, and genetic evidence suggests GPP distinct clinical entity from plaque requires separate diagnosis. The interleukin-36 pathway appears central pathogenesis. As no therapeutic agents have been approved for date in the United States or Europe, introduction of anti-IL-36 therapies may change management. Areas covered: Using PubMed Google Scholar, we reviewed literature articles related GPP, psoriasis, genetics, pathogenesis, treatment thereof. Expert opinion: New options updated guidelines are needed. Ideal would rapid onset action time achieve clearance, ability prevent acute flares avert recurrence, possess favorable safety profile. Such should readily accessible via approval listing on formularies. Scoring systems establish burden objective outcome measures could also help with further evaluation access issues. IL-36 remains promising target, as supported by early phase data suggesting efficacy novel therapy.

Language: Английский

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Inclusion of pregnant women in COVID-19 treatment trials: a review and global call to action

The Lancet Global Health, Journal Year: 2020, Volume and Issue: 9(3), P. e366 - e371

Published: Dec. 17, 2020

Inclusion of pregnant women in COVID-19 clinical trials would allow evaluation effective therapies that might improve maternal health, pregnancy, and birth outcomes, avoid the delay developing treatment recommendations for women. We explored inclusion by reviewing ten international trial registries at two timepoints 2020. identified 155 studies non-biological drugs April 7-10, 2020 timepoint, which 124 (80%) specifically excluded The same registry search July 10-15, yielded 722 studies, 538 (75%) then focused on included least one six (remdesivir, lopinavir-ritonavir, interferon beta, corticosteroids, chloroquine hydroxychloroquine, ivermectin) under COVID-19. Of 176 such 130 (74%) listed pregnancy as an exclusion criterion. 35 evaluated high-dose vitamin COVID-19, 27 (77%) Despite surge proportion excluding remains consistent. Exclusion was not well justified many treatments being have no or low safety concerns during pregnancy. is urgently needed to identify this population.

Language: Английский

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EASL Clinical Practice Guidelines on the management of liver diseases in pregnancy

Journal of Hepatology, Journal Year: 2023, Volume and Issue: 79(3), P. 768 - 828

Published: July 1, 2023

Language: Английский

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Efficacy of Corticosteroids in Patients With Recurrent Pregnancy Loss: A Systematic Review and Meta‐Analysis

American Journal of Reproductive Immunology, Journal Year: 2025, Volume and Issue: 93(1)

Published: Jan. 1, 2025

ABSTRACT Recurrent pregnancy loss (RPL) represents a complication of occurring in 1%–3% all couples trying to conceive. About 50%–60% RPL cases remain idiopathic, therefore therapeutic strategies seem empirical and based on unproven evidence. We investigated the efficacy corticosteroids women with RPL. conducted systematic review meta‐analysis, up August 2024, PubMed, Scopus, Web Science databases, including studies idiopathic comparing versus control treatment. Primary outcome was ongoing rate beyond 12 weeks gestation; secondary outcomes were live birth (LBR), stillbirth, weight, incidence preeclampsia and/or gestational diabetes, age at delivery, fetal abnormalities. Four comprising 417 randomly assigned steroid or treatment included. found that oral significantly increase gestation compared group (log OR [odds ratio] = 1.49 [0.32, 2.67], p 0.01), high heterogeneity ( I 2 75%), improve LBR 0.9 [0.11, 1.69], 0.03), low 0.05%). However, limited number limits strength findings. Also, benefit/risk assessment use early for is still unclear.

Language: Английский

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Neuromyelitis optica spectrum disorders and pregnancy: therapeutic considerations

Nature Reviews Neurology, Journal Year: 2020, Volume and Issue: 16(3), P. 154 - 170

Published: Feb. 20, 2020

Language: Английский

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Exposure to corticosteroids in pregnancy is associated with adverse perinatal outcomes among infants of mothers with inflammatory bowel disease: results from the PIANO registry

Gut, Journal Year: 2021, Volume and Issue: 71(9), P. 1766 - 1772

Published: Oct. 22, 2021

Objective Active inflammatory bowel disease (IBD) during pregnancy may require the use of corticosteroids. The aim this study was to investigate impact in utero corticosteroid exposure on adverse outcomes, congenital malformations, infections and neurocognitive development among offspring mothers with IBD. Design Using prospective Pregnancy Inflammatory Bowel Disease Neonatal Outcomes registry, data were collected at each trimester, delivery; 12 months post partum. Bivariate statistics multivariate logistic regression models compared outcomes by exposure. Results A total 1490 IBD enrolled, 1431 live births recorded. Corticosteroid associated increased risk preterm birth, small for gestational age, low birth weight (LBW), intrauterine growth restriction neonatal intensive care unit (NICU) admission. On adjusted models, (OR 1.79, 95% CI 1.18 2.73), LBW 1.76, 1.07 2.88) NICU admission 1.54, 1.03 2.30). Late (second and/or third trimester) serious 9 (4% vs 2% 5% 2%, respectively, p=0.03 p=0.001). There five newborns born orofacial clefts versus one without Developmental milestones similar across groups. Conclusion In women exposed corticosteroids more likely have outcomes. This emphasises importance controlling activity before steroid-sparing therapy.

Language: Английский

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What Can We Learn from Sex Differences in MS?

Journal of Personalized Medicine, Journal Year: 2021, Volume and Issue: 11(10), P. 1006 - 1006

Published: Oct. 7, 2021

Multiple sclerosis (MS) is the major acquired central nervous system disease of young adults. It a female predominant disease. aspects MS are influenced by sex-based differences. This has become an important area research and study. teaches us how impact sex on can lead to new insights, guidelines, management, treatments.

Language: Английский

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The impact of gender and sex in psoriasis: What to be aware of when treating women with psoriasis

International Journal of Women’s Dermatology, Journal Year: 2022, Volume and Issue: 8(2), P. e010 - e010

Published: April 13, 2022

Psoriasis is a common chronic inflammatory skin disease with an exceptionally high burden for women.Sex-dependent differences in manifestation, severity, treatment choices, subjective perception, and the impact on quality of life risk factors are described comprehensively discussed.A literature search was conducted using MEDLINE (PubMed) Cochrane Library systematic reviews to investigate challenges treating women psoriasis.The incidence, prevalence, manifestation psoriasis similar between different sexes. Genetic environmental such as obesity metabolic syndrome not equally relevant or pronounced men. Overall, have lower severity measured by Area Severity Index, which associated higher impairment their Dermatology Life Quality Index compared In addition, more likely depression than Hormonal affect psoriasis, correlation estrogen levels improvement psoriasis. Data regarding prescribing patterns systemic treatments entirely consistent. Registry studies show that men tend severe and, some cases, prescribed therapies frequently. Women respond better experience adverse events. Treatment options same both sexes, except during pregnancy lactation. Various contraindicated due fear fetal neonate harm lack data. Topical steroids can be degree safety pregnancy. For other topical (calcineurin inhibitors vitamin D analogs), no effects available, data mainly stem from examining after administration. Antitumor necrosis factor monoclonal antibodies (except certolizumab pegol) been possible increased preterm birth, low gestational age, cesarean deliveries. Prospective biologics antitumor factor-alpha accurately assess whether novel (eg, anti-interleukin 17, 12/23, 23) used therapy lacking currently being conducted.

Language: Английский

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