Background RA is one of the autoimmune disease, often generated in a middle-aged woman and the patient of reproductive age is not few either. We set up the registry of RA patients treated using biologics named Tsurumai Biologics Communication Registry (TBCR) and collected 2072 cases until now.
Objectives The evidence of treatment with Disease Modifying Anti Rheumatic Drugs (DMARDs) for the pregnant RA patient is limited. It is very difficult to give what kind of medication for them because of a possibility of the pregnancy. The aim of this study is to investigate how the pregnant patients in TBC registry were treated with biologics.
Methods The usage of biological agents including tumor necrosis factor inhibitors and interleukin-6 inhibitors before or during pregnancy and the outcome of pregnancy in patients with rheumatoid arthritis (RA) were investigated using TBCR until December, 2011.
Results 30 pregnancies in 26 female patients with RA were identified among 2072 patients during 8-year registry periods (22 with ETN exposure, 2 with INF exposure and 6 with TCZ exposure). Biological agents were prescribed at conception in 19 pregnancies (63.3%) among which etanercept and tocilizumab were used in 15and 4, respectively. Although biological agents were prescribed during pregnancy after conception in no case, oral prednisolone was prescribed more frequently during pregnancy (70.0%) than before planning pregnancy (36.0%). Although 3 premature deliveries and 4 spontaneous abortions occurred, no anomalies of infants were observed.
Conclusions In this study, we reported how the biologic agents used in young female RA patients and how many pregnancies were occurred in TBC registry. It is difficult to do clinical research about safety of drug for the pregnancy. Although the usage of biological agents, especially etanercept, is one of the choices in the strategy of pregnancy in patients with active RA, firm conclusion on safety of etanercept use during pregnancy is difficult to describe from the results of this retrospective study without control. More information on association between biological agents and pregnancy in RA patients should be collected in the future.
Disclosure of Interest None Declared
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