Hydroxychloroquine (HCQ) is nearly universally recommended for pregnant patients with systemic lupus erythematosus (SLE) to reduce lupus disease activity and adverse outcomes in pregnancy.1-3 Yet despite strong evidence supporting its benefits, HCQ appears underutilized, with several studies suggesting fewer than half of all women with lupus take this medication during pregnancy.4 How accurately these results…
How does a rheumatologist treat a pregnant woman when many medications are not approved for pregnancy or safety data are limited?
You are a rheumatologist in Texas. You are very well trained. Your mentors included some of the leaders in rheumatology, and you are respected by your colleagues and your patients. You know the devastation of untreated rheumatoid arthritis and lupus. A young woman with recent onset of systemic lupus erythematosus is your new patient. You…
Rheumatologists should take an active role in patients’ reproductive health, including before, during and after pregnancy. Two experts offer insights into how rheumatologists can better care for their patients during these critical times.
In light of new challenges to individuals’ reproductive rights and the known challenges of clinical management of rheumatic disease patients during pregnancy, we review the current state of reproductive rheumatology and the management of patients with rheumatic disease during pregnancy.
Many women with inflammatory arthritis stop filling prescriptions for medications to treat their disease during pregnancy, putting themselves at risk of disability and joint damage. Birru Talabi et al. examined why, finding that some women discontinue their medications out of fear, while others receive conflicting advice from providers or misinformation about medication safety.
Secher et al. evaluated the risk of pre-eclampsia in pregnant patients with RA, axSpA or PsA, assessing the effect of disease activity and disease-modifying anti-rheumatic drugs on this risk.
Chambers et al. found no evidence of an increased risk of major structural birth defects nor any increase in a wide range of other pregnancy outcomes attributable to prenatal exposure to hydroxychloroquine.
A study was able to quantify the transference of tumor necrosis factor (TNF) inhibitors from mother to fetus during pregnancy. Overall, the researchers found low levels of transfer for the treatments studied.
Rheumatologists play a critical role in the reproductive health of their patients, but only half of rheumatologists currently ask their patients about reproductive health or family planning issues. A new guideline seeks to change that.