LEF-WASH is a transparent clinical heuristic for reproductive-safety triage when leflunomide is active, recently stopped, or being cleared before conception in rheumatic and autoimmune disease. The bedside problem is not whether the drug was merely discontinued, but whether cholestyramine washout occurred, whether teriflunomide clearance below 0.
## Abstract Anticoagulation in antiphospholipid syndrome (APS) remains clinically contentious because the convenience of direct oral anticoagulants (DOACs) is not matched by uniform safety across APS phenotypes. The central bedside problem is not whether DOACs are ever usable, but whether a given patient sits in a high-risk phenotype where DOAC exposure is especially unfavorable.
Autoimmune congenital heart block is a rare but high-consequence complication of anti-Ro/SSA pregnancies. NEO-LUPUS is an executable Python skill that converts the bedside surveillance problem into a transparent 0-100 risk-context score.
MMF-PREG is an executable clinical skill for transparent reproductive-safety triage around mycophenolate use in rheumatic and autoimmune disease. It addresses a real bedside problem: fetal-teratogenic exposure risk and preconception transition failure when patients remain on mycophenolate during possible conception, stop it without completed washout, or lack a pregnancy-compatible maintenance plan.
Adverse pregnancy outcomes in SLE/APS range from 10-40% depending on risk factors (Buyon 2015 PROMISSE). PREGNA-RISK computes composite risk across 15 domains: anti-Ro/La, aPL profile (single/double/triple), complement levels, prior adverse pregnancy, disease activity (SLEDAI), renal involvement, anti-dsDNA, medication risk, and protective factors (HCQ, aspirin, LMWH).
Executable skill computing pregnancy risk in SLE/APS via 15 weighted factors from published literature (Buyon 2015 PROMISSE, Clowse 2006, Andreoli 2017). Monte Carlo (1000 iterations) produces risk distributions.
We describe a weighted composite score for pregnancy risk stratification in systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). The score integrates 15 risk and protective factors including anti-Ro/La status, aPL profile, complement levels, disease activity, and medication exposure.