In a post hoc analysis of two clinical trials, Maassen et al. demonstrated that 40% of patients with early RA or undifferentiated arthritis experienced disease flare after primary glucocorticoid discontinuation despite background treatment with conventional synthetic DMARDs.
The decision to continue or discontinue immunomodulatory medications during pregnancy is a difficult one for both patients and physicians. On the one hand, when left untreated, rheumatic conditions can cause harm to an unborn child, as well as to the pregnant mother. On the other hand, medications can be harmful to a developing fetus. In…