Background Guidelines and recommendations regarding risk and safety of antirheumatic drugs during pregnancy and lactation from professional societies vary considerable between countries
Objectives A EULAR task force was established to reach a consensus on antirheumatic drugs during pregnancy and lactation.
Methods A systematic search of the literature for publications on classic antirheumatic and biological drugs during pregnancy and lactation was performed. A statement in regard to pregnancy and lactation was made and the strength of evidence for “points to consider” was based on customary scoring systems. Delphi voting was applied to assess the level of agreement between task force members.
Results The systematic literature search for the period 2006-2015 retrieves an increasing documentation on the use of antirheumatic drugs in pregnant women, and the outcome of their pregnancies. This is particularly apparent regarding the TNF-inhibitors (Table 1). However, only few reports are prospective studies, and include a control group. Publications on drugs used during breastfeeding are very rare and lack completely for several antirheumatic drugs.
Conclusions The international consensus of ‘Points to consider’ will support the clinicians in counseling patients desiring children, and will meet the needs of 60-80% of patients with rheumatic diseases planning pregnancy who seek information on medication from health professionals and the internet.
Østensen M, Khamashta MA, Lockshin M, et al. Anti-inflammatory and immunosuppressive drugs and reproduction. Arthritis Res Ther 2006; 8: 209
Disclosure of Interest None declared