Updated pharmacological management of rheumatoid arthritis for women before, during, and after pregnancy, reflecting recent guidelines

Irish Journal of Medical Science
Kieran E MurrayDouglas J Veale

Abstract

Rheumatoid arthritis (RA) is a chronic immune-mediated inflammatory disease which can cause significant disability, morbidity, mortality, and impaired fertility. It commonly affects women of childbearing age. Managing rheumatoid arthritis (RA) in the perinatal period poses challenges. There is concern about the teratogenic effects of many traditional disease-modifying anti-rheumatic drugs (DMARDs) and an ever-growing list of new therapeutic options with limited data in pregnancy and breastfeeding. We aimed to create a standardized approach to pharmacological management of RA patients seen in our newly established Rheumatology and Reproductive Health Service. We reviewed relevant publications on the use of anti-rheumatic drugs in pregnancy. These include recent guidelines from The British Society for Rheumatology (BSR) and British Health Professionals in Rheumatology (BHPR) and the European League Against Rheumatism (EULAR). After considering relevant publications, we developed a Saint Vincent's University Hospital/National Maternity Hospital consensus protocol for evidence-based medication in pregnancy in RA. RA tends to improve during pregnancy and flare postpartum. Several anti-rheumatic medication options during pregnancy an...Continue Reading

References

Sep 2, 2008·Arthritis and Rheumatism·Yaël A de ManJohanna M W Hazes
Dec 24, 2013·Acta Obstetricia Et Gynecologica Scandinavica·Marianne WalleniusJohan F Skomsvoll
May 17, 2014·Annals of the Rheumatic Diseases·Jenny BrouwerRadboud J E M Dolhain
Oct 25, 2014·Therapeutic Advances in Musculoskeletal Disease·Megan L KrauseAshima Makol
Jan 4, 2015·Autoimmunity Reviews·Monika ØstensenMichael von Wolff

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Citations

May 28, 2020·Inflammation Research : Official Journal of the European Histamine Research Society ... [et Al.]·Abolfazl FattahSaeed Aslani
Aug 19, 2020·Diagnostics·Anca Marina CiobanuAnca Maria Panaitescu
Jan 15, 2021·Arthritis Research & Therapy·Kieran MurrayDouglas J Veale
Jan 9, 2020·Arthritis Care & Research·Alessandra BortoluzziUNKNOWN Record-Linkage on Rheumatic Diseases Study of the Italian Society for Rheumatology
Dec 4, 2019·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·Emily IngramLaura M Borgelt

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