RT Journal Article SR Electronic T1 The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation JF Annals of the Rheumatic Diseases JO Ann Rheum Dis FD BMJ Publishing Group Ltd and European League Against Rheumatism SP 795 OP 810 DO 10.1136/annrheumdis-2015-208840 VO 75 IS 5 A1 Götestam Skorpen, Carina A1 Hoeltzenbein, Maria A1 Tincani, Angela A1 Fischer-Betz, Rebecca A1 Elefant, Elisabeth A1 Chambers, Christina A1 da Silva, Josè A1 Nelson-Piercy, Catherine A1 Cetin, Irene A1 Costedoat-Chalumeau, Nathalie A1 Dolhain, Radboud A1 Förger, Frauke A1 Khamashta, Munther A1 Ruiz-Irastorza, Guillermo A1 Zink, Angela A1 Vencovsky, Jiri A1 Cutolo, Maurizio A1 Caeyers, Nele A1 Zumbühl, Claudia A1 Østensen, Monika YR 2016 UL http://ard.bmj.com/content/75/5/795.abstract AB A European League Against Rheumatism (EULAR) task force was established to define points to consider on use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Based on a systematic literature review and pregnancy exposure data from several registries, statements on the compatibility of antirheumatic drugs during pregnancy and lactation were developed. The level of agreement among experts in regard to statements and propositions of use in clinical practice was established by Delphi voting. The task force defined 4 overarching principles and 11 points to consider for use of antirheumatic drugs during pregnancy and lactation. Compatibility with pregnancy and lactation was found for antimalarials, sulfasalazine, azathioprine, ciclosporin, tacrolimus, colchicine, intravenous immunoglobulin and glucocorticoids. Methotrexate, mycophenolate mofetil and cyclophosphamide require discontinuation before conception due to proven teratogenicity. Insufficient documentation in regard to fetal safety implies the discontinuation of leflunomide, tofacitinib as well as abatacept, rituximab, belimumab, tocilizumab, ustekinumab and anakinra before a planned pregnancy. Among biologics tumour necrosis factor inhibitors are best studied and appear reasonably safe with first and second trimester use. Restrictions in use apply for the few proven teratogenic drugs and the large proportion of medications for which insufficient safety data for the fetus/child are available. Effective drug treatment of active inflammatory rheumatic disease is possible with reasonable safety for the fetus/child during pregnancy and lactation. The dissemination of the data to health professionals and patients as well as their implementation into clinical practice may help to improve the management of pregnant and lactating patients with rheumatic disease.