Management of RA medications in pregnant patients

Østensen, Monika; Förger, Frauke (2009). Management of RA medications in pregnant patients. Nature reviews - rheumatology, 5(7), pp. 382-90. New York, N.Y.: Nature Publishing Group 10.1038/nrrheum.2009.103

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A desire for children or the presence of pregnancy limits the drug therapy options for a woman with rheumatoid arthritis. Combination therapies that include methotrexate or new drugs that have not been studied or used in pregnant patients must be excluded, even though they might be highly efficacious. With few exceptions, the reason for this exclusion is not the proven teratogenicity of the drugs, but the absence of proven safety for the fetus. Whereas methotrexate, leflunomide, abatacept and rituximab must be withdrawn before a planned pregnancy, tumor necrosis factor inhibitors and bisphosphonates can be continued until conception. Antimalarial agents, sulfasalazine, azathioprine and ciclosporin are compatible with pregnancy, and so can be administered until birth. Corticosteroids and analgesics such as paracetamol (acetaminophen) can also be used throughout pregnancy. NSAIDs can be safely administered until gestational week 32. The most important consideration when managing rheumatoid arthritis medications during pregnancy is that therapy must be tailored for the individual patient according to disease activity.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology, Clinical Immunology and Allergology

UniBE Contributor:

Oestensen, Monika Elisabeth and Förger, Frauke

ISSN:

1759-4790

Publisher:

Nature Publishing Group

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:11

Last Modified:

04 May 2014 23:22

Publisher DOI:

10.1038/nrrheum.2009.103

PubMed ID:

19506586

Web of Science ID:

000267509100008

URI:

https://boris.unibe.ch/id/eprint/31412 (FactScience: 195919)

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