Skip to main content

Advertisement

SpringerLink
Log in

The treatment of rheumatoid arthritis during pregnancy

  • Review
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

There are a wide variety of medications available to treat patients with rheumatoid arthritis, many of which are considered unsafe during pregnancy. It is important to tailor a treatment regimen that stabilises the woman’s disease prior to conception, using medications that are safe to continue throughout pregnancy and the post-partum period. Drugs that may be safely used during pregnancy include NSAIDs, corticosteroids, plus several DMARDs, including sulfasalazine and hydroxychloroquine. Drugs recommended to be stopped before pregnancy include methotrexate and leflunomide, plus the biologics: anti-TNF agents, rituximab and abatacept.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Deighton C, Luqmani R (2009) The NICE and BSR guidelines on the management of rheumatoid arthritis (online). Autumn No. 4. Available from http://www.arc.org.uk/arthinfo/medpubs/6544/6544.asp. Accessed 12 Jan 2010

  2. Barrett JH, Brennan P, Fiddler M, Silman AJ (1999) Does rheumatoid arthritis remit during pregnancy and relapse postpartum? Results from a nationwide study in the United Kingdom performed prospectively from late pregnancy. Arthritis Rheum 42:1219–1227. Available from http://www3.interscience.wiley.com/cgi-bin/fulltext/79503251/PDFSTART. Accessed 12 Jan 2010

  3. Silman AJ, Kay A, Brennan P (1992) Timing of pregnancy in relation to the onset of rheumatoid arthritis (abstract). Arthritis Rheum 35:152–155. Available from http://www.ncbi.nlm.nih.gov/pubmed/1734904?dopt=Abstract. Accessed 12 Jan 2010

  4. Torfs CP, Katz EA, Bateson TF, Lam PK, Curry CJ (1996) Maternal medications and environmental exposures as risk factors for gastroschisis (abstract). Teratology 54:84–92. Available from http://www.ncbi.nlm.nih.gov/pubmed/8948544?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=3. Accessed 12 Jan 2010

  5. Nielsen GL, Sorensen HT, Larsen H, Pedersen L (2001) Risk of adverse birth outcome and miscarriage in pregnant users of non-steroidal anti-inflammatory drugs: population-based observational study and case-control study. BMJ 322:266–270. Available from http://www.bmj.com/cgi/content/full/322/7281/266?view=long&pmid=11157526. Accessed 12 Jan 2010

  6. Østensen M, Förger F (2009) Management of RA medications in pregnant patients. Nat Rev Rheumatol 5:382–390. Available from http://www.nature.com/nrrheum/journal/v5/n7/pdf/nrrheum.2009.103.pdf. Accessed 12 Jan 2010

    Google Scholar 

  7. Keeling SO, Oswald AE (2009) Pregnancy and rheumatic disease: “by the book” or “by the doc”. Clin Rheumatol 28:1–9. Available from http://www.springerlink.com/content/c7272331544204n3/fulltext.html. Accessed 12 Jan 2010

    Google Scholar 

  8. Chambers CD, Tutuncu ZN, Johnson D, Jones KL (2006) Human pregnancy safety for agents used to treat rheumatoid arthritis: adequacy of available information and strategies for developing post-marketing data. Arthritis Res Ther 8:225–235. Available from http://arthritis-research.com/content/pdf/ar1977.pdf. Accessed 12 Jan 2010

  9. Hernández-Díaz S, Werler MM, Walker AM, Mitchell AA (2000) Folic acid antagonists during pregnancy and the risk of birth defects. N Engl J Med 343:1608–1614. Available from http://content.nejm.org/cgi/content/abstract/343/22/1608. Accessed 12 Jan 2010

    Google Scholar 

  10. Costedoat-Chalumeau N, Amoura Z, Duhaut P, Huong DLT, Sebbough D, Wechsler B, Vauthier D, Denjoy I, Lupoglazoff J-M, Piette J-C (2003) Safety of hydroxychloroquine in pregnant patients with connective tissue diseases. Arthritis Rheum 48:3207–3211

    Article  PubMed  CAS  Google Scholar 

  11. Roux CH, Brocq O, Breuil V, Albert C, Euller-Ziegler L (2007) Pregnancy in rheumatology patients exposed to anti-tumour necrosis factor (anti-TNF)-α therapy. Rheumatology 46:695–698

    Article  PubMed  CAS  Google Scholar 

  12. Chambers C, Koren G, Tutuncu ZN, Johnson D, Jones KL (2007) Are new agents used to treat rheumatoid arthritis safe to take during pregnancy? Can Fam Physician 53:409–412

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Bart’s and The London School of Medicine and Dentistry, University of London, London, UK

    Rosamund Partlett & Euthalia Roussou

  2. Department of Rheumatology and Rehabilitation, Barking Havering and Redbridge University Hospitals NHS Trust, King George Hospital, Barley Lanes, Goodmayes, Ilford, Essex, London, IG3 8YB, UK

    Euthalia Roussou

Authors
  1. Rosamund Partlett
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Euthalia Roussou
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Euthalia Roussou.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Partlett, R., Roussou, E. The treatment of rheumatoid arthritis during pregnancy. Rheumatol Int 31, 445–449 (2011). https://doi.org/10.1007/s00296-010-1643-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-010-1643-7

Keywords

Search

Navigation