2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/2iy5wruuedsh6.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/00yc7rcvua6a7.js","/_next/static/immutable/chunks/37ktb71aq3480.js","/_next/static/immutable/chunks/2d50b-7eu4558.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/2d6noqpp6ehas.js","/_next/static/immutable/chunks/1sx186c93bpzg.js","/_next/static/immutable/chunks/3dc-1n866s65i.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2w1bvggzb0ga8.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T695,To describe disease activity and treatments received during the postpartum period, breastfeeding rates and their possible impact on rheumatoid arthritis (RA) and spondyloarthritis (SpA) activity. This ancillary study from the French multicentre prospective cohort (GR2-NCT02450396) included pregnant women with RA and SpA with at least one postpartum visit from October 2014 to October 2022. Disease activity, flares, treatments and breastfeeding rates were described. Factors associated with the occurrence of a flare were evaluated by survival analysis. Disease activity was compared according to breastfeeding duration (never, <6 months and ≥6 months). Ninety-four RA and 124 SpA patients were studied. In RA patients, the proportion of patients presenting with at least one flare was significantly higher during the first 6 months postpartum compared with pregnancy (62.0% vs 43.5%; p=0.02). For SpA patients, there was no difference in disease activity at 6 months postpartum compared with pregnancy (40.7% vs 40.7%; p=0.999). Disease activity in postpartum was similar between the different breastfeeding status in both diseases. 13/91 (14.3%) RA patients and 29/123 (23.6%) SpA patients continued a biologic Disease-Modifying Antirheumatic Drug (bDMARD) during the whole pregnancy and the postpartum. 78/91 RA and 94/123 SpA patients delivered without any DMARDs, and among them, 43/78 (55.1%) and 56/94 (59.6%) (re)started a bDMARD postpartum. RA patients were more likely to flare during early postpartum, while SpA patients remained stable. bDMARD continuation during pregnancy was more frequent in SpA patients, and half of the patients restarted bDMARD during postpartum.31:T9b8, Objective To describe disease activity and treatments received during the postpartum period, breastfeeding rates and their possible impact on rheumatoid arthritis (RA) and spondyloarthritis (SpA) activity. Method This ancillary study from the French multicentre prospective cohort (GR2- NCT02450396 ) included pregnant women with RA and SpA with at least one postpartum visit from October 2014 to October 2022. Disease activity, flares, treatments and breastfeeding rates were described. Factors associated with the occurrence of a flare were evaluated by survival analysis. Disease activity was compared according to breastfeeding duration (never, <6 months and ≥6 months). Results Ninety-four RA and 124 SpA patients were studied. In RA patients, the proportion of patients presenting with at least one flare was significantly higher during the first 6 months postpartum compared with pregnancy (62.0% vs 43.5%; p=0.02). For SpA patients, there was no difference in disease activity at 6 months postpartum compared with pregnancy (40.7% vs 40.7%; p=0.999). Disease activity in postpartum was similar between the different breastfeeding status in both diseases. 13/91 (14.3%) RA patients and 29/123 (23.6%) SpA patients continued a biologic Disease-Modifying Antirheumatic Drug (bDMARD) during the whole pregnancy and the postpartum. 78/91 RA and 94/123 SpA patients delivered without any DMARDs, and among them, 43/78 (55.1%) and 56/94 (59.6%) (re)started a bDMARD postpartum. Conclusion RA patients were more likely to flare during early postpartum, while SpA patients remained stable. bDMARD continuation during pregnancy was more frequent in SpA patients, and half of the patients restarted bDMARD during postpartum. 32:T789,The guideline panel agreed on 16 recommendations, of which 1 is a strong recommendation, 9 are conditional recommendations, and 6 were identified as knowledge gaps. In adult patients with moderate-to-severely active CD, the AGA recommends the use of infliximab, adalimumab, ustekinumab, risankizumab, mirikizumab, guselkumab, or upadacitinib over no treatment, and suggests the use of certolizumab pegol or vedolizumab over no treatment. In individuals who are naïve to advanced therapies, the AGA suggests using a higher efficacy medication (infliximab, adalimumab, vedolizumab, ustekinumab, risankizumab, mirikizumab, or guselkumab) rather than a lower-efficacy medication (certolizumab pegol or upadacitinib). In individuals who have previously been exposed to 1 or more advanced therapies, the AGA suggests using a higher efficacy medication (adalimumab, risankizumab, guselkumab, or upadacitinib) or intermediate efficacy medication (ustekinumab or mirikizumab) rather than a lower efficacy medication (vedolizumab or certolizumab pegol). In adult outpatients with moderate-to-severely active CD, the AGA suggests against using thiopurine monotherapy for induction of remission, but suggests using thiopurine monotherapy over no treatment for maintenance of (typically corticosteroid-induced) remission. The AGA suggests using subcutaneous methotrexate for induction and maintenance of remission, but suggests against using oral methotrexate. The AGA suggests using combination therapy with infliximab and thiopurines over infliximab monotherapy, particularly in those naïve to thiopurines. The AGA also suggests using initial advanced therapy over step therapy involving corticosteroids and/or immunomodulators in patients with moderate-to-severely active CD. The panel also proposed key implementation considerations for optimal use of these medications, identified several knowledge gaps, and areas for future research.33:Ta0c,This American Gastroenterological Association (AGA) living guideline is intended to support practitioners in the pharmacologic management of moderate-to-severely active Crohn's disease (CD). A multidisciplinary panel of clinical experts and methodologists used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework to prioritize clinical questions, identify patient-centered outcomes, conduct an evidence synthesis, and develop recommendations. The guideline panel agreed on 16 recommendations, of which 1 is a strong recommendation, 9 are conditional recommendations, and 6 were identified as knowledge gaps. In adult patients with moderate-to-severely active CD, the AGA recommends the use of infliximab, adalimumab, ustekinumab, risankizumab, mirikizumab, guselkumab, or upadacitinib over no treatment, and suggests the use of certolizumab pegol or vedolizumab over no treatment. In individuals who are naïve to advanced therapies, the AGA suggests using a higher efficacy medication (infliximab, adalimumab, vedolizumab, ustekinumab, risankizumab, mirikizumab, or guselkumab) rather than a lower-efficacy medication (certolizumab pegol or upadacitinib). In individuals who have previously been exposed to 1 or more advanced therapies, the AGA suggests using a higher efficacy medication (adalimumab, risankizumab, guselkumab, or upadacitinib) or intermediate efficacy medication (ustekinumab or mirikizumab) rather than a lower efficacy medication (vedolizumab or certolizumab pegol). In adult outpatients with moderate-to-severely active CD, the AGA suggests against using thiopurine monotherapy for induction of remission, but suggests using thiopurine monotherapy over no treatment for maintenance of (typically corticosteroid-induced) remission. The AGA suggests using subcutaneous methotrexate for induction and maintenance of remission, but suggests against using oral methotrexate. The AGA suggests using combination therapy with infliximab and thiopurines over infliximab monotherapy, particularly in those naïve to thiopurines. The AGA also suggests using initial advanced therapy over step therapy involving corticosteroids and/or immunomodulators in patients with moderate-to-severely active CD. The panel also proposed key implementation considerations for optimal use of these medications, identified several knowledge gaps, and areas for future research. This guideline provides a comprehensive, patient-centered, evidence-based approach to the pharmacologic management of patients with moderate-to-severely active CD.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"certolizumab pegol: generic Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on certolizumab pegol (generic). Clinician-written summaries and actionable practice insights. 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The level of evidence is assigned as 3 (open-label controlled study without randomization); some may classify it differently given the single-arm design.","value_numeric":null}],"summaries":{"what_studied":"Pharmacokinetics, effectiveness, safety, and immunogenicity of certolizumab pegol (CZP) in 193 children and adolescents (ages 2–17) with polyarticular-course juvenile idiopathic arthritis (pcJIA) who had inadequate response or intolerance to ≥1 DMARD; followed for a median of 3.45 years (up to ~11.4 years) in a multicenter, open-label trial.","key_result":"At Week 16, 78.2% (151/193) achieved JIA ACR50; median JADAS-71 dropped from 23.5 at baseline to 4.0. Serious treatment-emergent adverse events occurred in 23.8% (46/193). Chronic anti-drug antibody positivity exceeded 79% by Week 12 and was linked to lower CZP levels but did not block clinical response.","limitations":"Open-label, single-arm design with no placebo or active comparator, limiting causal inference. Dose was adjusted mid-study after interim analyses, creating heterogeneous exposure groups. High immunogenicity rates (>79%) raise questions about long-term drug-level adequacy that cannot be fully answered without a controlled arm.","practice_takeaway":"CZP produced rapid and durable disease control in pediatric pcJIA across weight-based dosing tiers, with no new safety signals over 9+ years — a reassuring long-term profile for clinicians considering this agent in children who have failed DMARDs. Monitor for high rates of anti-drug antibody formation, though clinical response appears preserved despite lower drug levels."}},{"doi":"10.1136/rmdopen-2025-006593","pmid":"42049394","title":"Impact of postpartum on patients with rheumatoid arthritis and spondyloarthritis: an ancillary analysis of the GR2 prospective cohort","journal_title":"RMD Open","journal_issn":"2056-5933","published_at":"2026-04-29T00:00:00.000Z","url":"https://doi.org/10.1136/rmdopen-2025-006593","source_score":17,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-04-30","doi":"10.1136/rmdopen-2025-006593","days":"14","issn":"2056-5933","rank":"6","field":"Clinical Medicine","score":"17","category":"Rheumatology","categories":["Rheumatology"],"_categories":["Rheumatology"]},"pubmed":{"doi":"10.1136/rmdopen-2025-006593","title":"Impact of postpartum on patients with rheumatoid arthritis and spondyloarthritis: an ancillary analysis of the GR2 prospective cohort.","journal":"RMD open","methods":"This ancillary study from the French multicentre prospective cohort (GR2-NCT02450396) included pregnant women with RA and SpA with at least one postpartum visit from October 2014 to October 2022. Disease activity, flares, treatments and breastfeeding rates were described. Factors associated with the occurrence of a flare were evaluated by survival analysis. Disease activity was compared according to breastfeeding duration (never, <6 months and ≥6 months).","results":"Ninety-four RA and 124 SpA patients were studied. In RA patients, the proportion of patients presenting with at least one flare was significantly higher during the first 6 months postpartum compared with pregnancy (62.0% vs 43.5%; p=0.02). For SpA patients, there was no difference in disease activity at 6 months postpartum compared with pregnancy (40.7% vs 40.7%; p=0.999). Disease activity in postpartum was similar between the different breastfeeding status in both diseases. 13/91 (14.3%) RA patients and 29/123 (23.6%) SpA patients continued a biologic Disease-Modifying Antirheumatic Drug (bDMARD) during the whole pregnancy and the postpartum. 78/91 RA and 94/123 SpA patients delivered without any DMARDs, and among them, 43/78 (55.1%) and 56/94 (59.6%) (re)started a bDMARD postpartum.","abstract":"$30","keywords":["Arthritis, Rheumatoid","Axial Spondyloarthritis","Biological Therapy"],"pubmed_id":"42049394","conclusions":"RA patients were more likely to flare during early postpartum, while SpA patients remained stable. bDMARD continuation during pregnancy was more frequent in SpA patients, and half of the patients restarted bDMARD during postpartum.","publication_date":"2026-04-29T00:00:00"},"crossref":{"DOI":"10.1136/rmdopen-2025-006593","URL":"https://doi.org/10.1136/rmdopen-2025-006593","ISSN":["2056-5933"],"link":[{"URL":"https://syndication.highwire.org/content/doi/10.1136/rmdopen-2025-006593","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"e006593","type":"journal-article","issue":"2","score":1,"title":["Impact of postpartum on patients with rheumatoid arthritis and spondyloarthritis: an ancillary analysis of the GR2 prospective cohort"],"author":[{"given":"Marie","family":"Hornez","sequence":"first","affiliation":[{"name":"Service de Rhumatologie, Université de Lille, CHU Lille, Lille, France"}]},{"given":"Anna","family":"Molto","sequence":"additional","affiliation":[{"name":"Centre for Research in Epidemiology and Statistics, Université Paris Cité; Université Sorbonne Paris Nord; INSERM; INRAE, Paris, France"},{"name":"Service de Rhumatologie, Hôpital Bichat, APHP, Paris, France"}]},{"given":"Maxime","family":"Leroy","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, CHU Lille, Lille, France"}]},{"given":"Béatrice","family":"Banneville","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Sorbonne Université and Pitié Salpêtrière Hospital, Paris, France"}]},{"given":"Rakiba","family":"Belkhir","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicetre, France"}]},{"given":"Elodie","family":"Chauvet","sequence":"additional","affiliation":[{"name":"Service de Médecine Interne, CHU Montpellier, Montpellier, France"}]},{"given":"Marion","family":"Couderc","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, CHU Gabriel Montpied, Clermont-Ferrand, France"}]},{"given":"Emmanuelle","family":"Dernis","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, CHU Caen, Caen, France"}]},{"given":"Valérie","family":"Devauchelle-Pensec","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, UMR1227, Lymphocytes B et Autoimmunité, Université de Bretagne occidentale, Inserm, CHU Brest, LabEx IGO, Brest, France"},{"name":"Rheumatology Unit, Centre National de Référence des Maladies Auto-Immunes Rares (CERAINOM), CHU, Brest, France"}]},{"given":"Aline","family":"Frazier","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Université Paris Cité, AP-HP, Hôpital Lariboisière, Paris, France"}]},{"given":"Laure","family":"Gossec","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Sorbonne Université and Pitié Salpêtrière Hospital, Paris, France"}]},{"given":"Elisabeth","family":"Gervais","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, CHU Poitiers, Poitiers, France"}]},{"given":"Hubert","family":"Marotte","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Université Jean Monnet Saint-Étienne, CHU Saint-Etienne, Mines Saint-Etienne, INSERM, SAINBIOSE U1059, Saint-Étienne, France"}]},{"given":"Christophe","family":"Richez","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, National Reference Center for Systemic Autoimmune Rare Diseases, Bordeaux University Hospital, Hôpital Pellegrin, Bordeaux, France"},{"name":"CNRS, Immunoconcept, UMR 5164, Bordeaux University, Bordeaux, France"}]},{"given":"Jérémie","family":"Sellam","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Hôpital Saint-Antoine; 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no brand-level data were reported in the paper.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"warning","value":"Definitions of flare and the specific disease activity measures are not provided in the abstract.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"warning","value":"Disease activity scores were frequently missing, especially CRP, which may have reduced sensitivity to detect objective changes in activity.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"warning","value":"Observational ancillary cohort analysis without randomized comparisons; causal inferences are limited.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"warning","value":"Self-reported flare definitions may overestimate true flare rates compared to validated score-based definitions.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"warning","value":"The association between bDMARD resumption and postpartum flare is likely reverse causation (flare prompts treatment restart) rather than treatment causing flare—authors acknowledge this.","value_numeric":null},{"paper_doi":"10.1136/rmdopen-2025-006593","tag_type":"warning","value":"Treatment denominators (e.g., 91/123) differ from total enrolled (94/124), suggesting missing data or exclusions.","value_numeric":null}],"summaries":{"what_studied":"An ancillary analysis of a French multicentre prospective cohort (GR2) followed pregnant women with rheumatoid arthritis (RA) or spondyloarthritis (SpA) who had at least one postpartum visit (2014–2022) to describe disease activity, flares, breastfeeding, and treatments. Postpartum disease activity was compared with pregnancy, flares were examined with survival analysis, and outcomes were explored by breastfeeding duration (never, <6 months, ≥6 months).","key_result":"In RA, the proportion with at least one flare in the first 6 months postpartum was higher than during pregnancy (62.0% vs 43.5%; p=0.02). In SpA, disease activity at 6 months postpartum was unchanged versus pregnancy (40.7% vs 40.7%; p=0.999); postpartum activity did not differ by breastfeeding status in either disease; 13/91 (14.3%) RA and 29/123 (23.6%) SpA continued a bDMARD through pregnancy and postpartum, and among those delivering without any DMARDs (RA 78/91; SpA 94/123), 43/78 (55.1%) and 56/94 (59.6%) (re)started a bDMARD postpartum.","limitations":"Only patients with at least one postpartum visit were included, and denominators varied across analyses (e.g., 91/123 vs totals 94/124), indicating missing data or exclusions. The abstract does not specify flare definitions or disease activity measures, and adjusted analyses are not reported.","practice_takeaway":"Plan closer monitoring of women with RA in the first 6 months after delivery, when flares were more frequent than during pregnancy; SpA activity appeared stable. 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