The Czech Society for Rheumatology standpoint for the treatment with antirheumatic drugs in pregnancy and lactation
Authors:
D. Tegzová; J. Vencovský
Authors‘ workplace:
Revmatologický ústav, Praha
Published in:
Čes. Revmatol., 26, 2018, No. 4, p. 143-152.
Category:
Recommendation
Overview
Pregnancy and lactation are periods of life that may be risky in female patients with rheumatic diseases. This risk arises from the nature of the rheumatic disease itself, from maternal therapy to conception and during pregnancy and lactation. The inflammatory activity of a given rheumatic disease is also dangerous for pregnancy, sometimes more than immunosuppressive therapy itself. The drugs used for pharmacotherapy in rheumatology are administered to a woman before conception, during pregnancy and lactation, and can have a significant adverse effect on both the mother and the fetus or the newborn. Non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, antimalarials, sulfasalazine, methotrexate, mycophenolate, azathioprine, cyclosporin A, cyclophosphamide, biological drugs, as well as anticoagulation and antiaggregation therapy are used to treat rheumatic diseases. The vast majority of these drugs have a certain risk for pregnancy. Individual anti-rheumatic drugs have different side effects in terms of pregnancy, and the possibility of using them is formulated on the basis of long-term safety data analysis of these drugs. Not all agents have sufficient information on their possible adverse effects in pregnancy. Such drugs should not be used during pregnancy. Treatment safety data is recorded long-term and evaluated and individual recommendations may change. This is especially true for new, mainly biological, drugs that have been available for a relatively short time and available data on their safety in pregnancy are still limited. The Commission of the European League against Rheumatism has proposed new recommendations for anti-rheumatic therapy for the conception period, pregnancy and lactation. Based on them the Czech Society for Rheumatology takes its stand on this issue.
Key words:
rheumatic diseases, pregnancy, lactation, pharmacotherapy
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Labels
Dermatology & STDs Paediatric rheumatology RheumatologyArticle was published in
Czech Rheumatology
2018 Issue 4
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