Disease activity during pregnancy in patients with rheumatoid arthritis or spondyloarthritis: results from the multicentre prospective GR2 study.

IF 2.5 Q3 RHEUMATOLOGY
Marion Couderc, Céline Lambert, Sabrina Hamroun, Denis Gallot, Nathalie Costedoat-Chalumeau, Laure Gossec, Gaëlle Guettrot-Imbert, Veronique Le Guern, Christophe Richez, Martin Soubrier, Anna Molto
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引用次数: 0

Abstract

Background: Pregnancy may have a beneficial effect on disease activity in rheumatoid arthritis (RA) but the evidence is more conflicting in spondyloarthritis (SpA). The aim of this study was to analyse disease activity and relapse during pregnancy in women with RA and SpA.

Methods: Consecutive pregnant women with RA or SpA were enrolled in this French multicentre observational cohort from 2014 to 2022. Women who had at least two prenatal visits (including one in the first trimester) were included in the analysis. Disease relapse was defined as treatment intensification (initiation or switch of a DMARD) or increase in disease activity scores (DAS28-CRP for RA patients; ASDAS-CRP and/or BASDAI for SpA patients).

Results: Of the 124 pregnant women included, 53 had RA and 71 had SpA. A total of 18 (35%) RA and 44 (62%) SPA received a TNF inhibitor during pregnancy. At the group level, disease activity indexes remained stable in the 1st, 2nd and 3rd trimesters. Disease relapse during pregnancy occurred in 17 (32%) RA patients and 28 (39%) SpA patients, among whom 30 (24%) requiring a treatment intensification. In multivariable analysis, factors associated with disease relapse were nulliparity (odds ratio, OR: 6.5, 95%CI: 1.1 to 37.9) and a disease flare in the 12 months prior to conception (OR: 8.2, 95%CI: 1.6 to 42.7) for RA patients, and a history of bDMARD use (OR: 5.4, 95%CI: 1.1 to 27.3) for SpA patients.

Conclusion: Disease activity remained stable during pregnancy in women with RA and SpA but almost a quarter required major changes to their treatment.

Abstract Image

Abstract Image

类风湿性关节炎或脊椎关节炎患者孕期疾病活动度:来自多中心前瞻性GR2研究的结果
背景:妊娠可能对类风湿关节炎(RA)的疾病活动性有有益的影响,但在脊椎关节炎(SpA)中,证据更加矛盾。本研究的目的是分析RA和SpA患者在怀孕期间的疾病活动和复发。方法:从2014年到2022年,连续患有RA或SpA的孕妇被纳入法国多中心观察队列。至少进行过两次产前检查(包括妊娠早期的一次)的妇女被纳入分析。疾病复发定义为治疗强化(启动或切换DMARD)或疾病活动性评分增加(RA患者的DAS28-CRP;ASDAS-CRP和/或BASDAI用于SpA患者)。结果:124例孕妇中,RA 53例,SpA 71例。共有18例(35%)RA和44例(62%)SPA在妊娠期间接受了TNF抑制剂治疗。在组水平上,疾病活动指数在妊娠1、2、3个月保持稳定。17例(32%)RA患者和28例(39%)SpA患者在妊娠期间出现疾病复发,其中30例(24%)需要强化治疗。在多变量分析中,与疾病复发相关的因素为RA患者的零生育(优势比,OR: 6.5, 95%CI: 1.1至37.9)和妊娠前12个月内的疾病爆发(OR: 8.2, 95%CI: 1.6至42.7),SpA患者的bDMARD使用史(OR: 5.4, 95%CI: 1.1至27.3)。结论:RA和SpA患者的疾病活动在怀孕期间保持稳定,但近四分之一的患者需要对其治疗进行重大改变。
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
BMC Rheumatology
BMC Rheumatology Medicine-Rheumatology
CiteScore
3.80
自引率
0.00%
发文量
73
审稿时长
15 weeks
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