Treatment of rheumatoid arthritis during pregnancy: present and future.

Förger, Frauke; Villiger, Peter (2016). Treatment of rheumatoid arthritis during pregnancy: present and future. Expert review of clinical immunology, 12(9), pp. 937-944. Taylor & Francis 10.1080/1744666X.2016.1184973

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INTRODUCTION

For the management of rheumatoid arthritis patients who plan to become pregnant, both disease activity and therapeutic regimens have to be taken into consideration. In the case of stable inactive disease, pregnancy can be planned and therapy can be adjusted with drugs compatible with pregnancy.

AREAS COVERED

Drugs to be discontinued before pregnancy are methotrexate, leflunomide, tocilizumab, rituximab, abatacept and tofacitinib. Pregnancy compatible disease modifying drugs are antimalarial drugs and sulfasalazine. TNF-inhibitors can be continued during the first half of pregnancy, yet if indicated during the third trimester TNF-inhibitors with a low rate of transplacental passage should be used. Glucocorticoids may be considered at the lowest effective dose throughout pregnancy. Non-selective COX-inhibitors can be continued until gestational week 32. Expert commentary: Together, a tailored treatment throughout pregnancy is possible with reasonable safety. Controlling disease activity during pregnancy is important for both, maternal and fetal health.

Item Type:	Journal Article (Review Article)
Division/Institute:	04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Rheumatologie 04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Rheumatologie 04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology and Immunology
UniBE Contributor:	Förger, Frauke, Villiger, Peter Matthias
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1744-8409
Publisher:	Taylor & Francis
Language:	English
Submitter:	Stefan Kuchen
Date Deposited:	17 May 2017 13:04
Last Modified:	05 Dec 2022 15:02
Publisher DOI:	10.1080/1744666X.2016.1184973
PubMed ID:	27170517
Uncontrolled Keywords:	DMARD; Pregnancy; TNF blockers; biologic agents; rheumatoid arthritis
URI:	https://boris.unibe.ch/id/eprint/95687