Treatment of spondyloarthritis with disease-modifying anti-rheumatic drugs during pregnancy and breastfeeding: comparing the recommendations and guidelines of the principal societies of rheumatology.

IF 1.2 Q4 RHEUMATOLOGY
M Manara, D Bruno, M Ferrito, S Perniola, R F Caporali, E Gremese
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引用次数: 0

Abstract

Objective: This paper aims to provide an overview of the use of treatments available for axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) during pregnancy and breastfeeding, according to current national recommendations and international guidelines, as well as data on the impact on pregnancy outcomes of paternal exposure to treatment.

Methods: We performed a narrative review of national and international recommendations and guidelines on the reproductive health of patients suffering from rheumatic diseases. The last updated recommendations and guidelines were considered source data.

Results: We reported updated information regarding the treatment of axSpA and PsA with nonsteroidal anti-inflammatory drugs, intra-articular glucocorticoids, conventional synthetic disease-modifying antirheumatic drugs (DMARDs), biologic DMARDs, and targeted synthetic DMARDs during the preconception period, pregnancy, and breastfeeding, as well as data related to paternal exposure. We highlighted any medications that should be discontinued and/or not used in the reproductive age group and also treatments that may be continued, avoiding the withdrawal of drugs that can be used in the different phases, thus preventing the risk of increasing disease activity and flares before, during, and after pregnancy in SpA patients.

Conclusions: The best management of pregnancy in patients with SpA is based on knowledge of updated drug recommendations, a careful and wise evaluation of the risks/benefits of starting or continuing treatment from the SpA diagnosis in a woman of childbearing age through pregnancy and lactation, and sharing therapeutic choices with other healthcare providers (in particular, gynecologists/obstetricians) and the patient.

妊娠期和哺乳期使用改变病情抗风湿药物治疗脊柱关节炎:比较主要风湿病学协会的建议和指南。
目的:本文旨在根据目前的国家建议和国际指南,概述轴性脊柱关节炎(axSpA)和银屑病关节炎(PsA)在妊娠期和哺乳期的治疗方法,以及父亲接受治疗对妊娠结局影响的数据:我们对有关风湿病患者生殖健康的国家和国际建议与指南进行了叙述性回顾。结果:我们报告了有关风湿病患者治疗的最新信息:我们报告了在孕前、孕期和哺乳期使用非甾体抗炎药、关节内糖皮质激素、传统合成改善病情抗风湿药(DMARDs)、生物 DMARDs 和靶向合成 DMARDs 治疗 axSpA 和 PsA 的最新信息,以及与父亲暴露相关的数据。我们强调了育龄期应停用和/或不用的药物,以及可继续使用的治疗方法,避免停用可在不同阶段使用的药物,从而防止SpA患者在妊娠前、妊娠期间和妊娠后增加疾病活动和复发的风险:对SpA患者妊娠期的最佳管理是基于对最新药物建议的了解,对育龄妇女从SpA诊断到妊娠期和哺乳期开始或继续治疗的风险/益处进行仔细而明智的评估,并与其他医疗服务提供者(尤其是妇科医生/产科医生)和患者分享治疗选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Reumatismo
Reumatismo RHEUMATOLOGY-
CiteScore
2.10
自引率
7.10%
发文量
20
审稿时长
10 weeks
期刊介绍: Reumatismo is the official Journal of the Italian Society of Rheumatology (SIR). It publishes Abstracts and Proceedings of Italian Congresses and original papers concerning rheumatology. Reumatismo is published quarterly and is sent free of charge to the Members of the SIR who regularly pay the annual fee. Those who are not Members of the SIR as well as Corporations and Institutions may also subscribe to the Journal.
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