The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu konsensus - konference, časopisecké články, systematický přehled
PubMed
26888948
DOI
10.1136/annrheumdis-2015-208840
PII: S0003-4967(24)01873-9
Knihovny.cz E-zdroje
- Klíčová slova
- DMARDs (biologic), DMARDs (synthetic), Nursing, Treatment,
- MeSH
- abnormality vyvolané léky prevence a kontrola MeSH
- antirevmatika škodlivé účinky terapeutické užití MeSH
- biologické přípravky škodlivé účinky terapeutické užití MeSH
- delfská metoda MeSH
- komplikace těhotenství farmakoterapie MeSH
- laktace * MeSH
- lidé MeSH
- maternofetální výměna látek MeSH
- novorozenec MeSH
- péče před početím metody MeSH
- revmatické nemoci farmakoterapie MeSH
- těhotenství MeSH
- výsledek těhotenství MeSH
- zpožděný efekt prenatální expozice MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- konsensus - konference MeSH
- systematický přehled MeSH
- Názvy látek
- antirevmatika MeSH
- biologické přípravky MeSH
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.
Department of Mother and Child Hospital Luigi Sacco University of Milano Milano Italy
Department of Pediatrics University of California San Diego La Jolla USA
Department of Rheumatology Erasmus MC University Medical Center Rotterdam Rotterdam The Netherlands
Department of Rheumatology Immunology and Allergology University Hospital of Bern Bern Switzerland
Department of Rheumatology University Hospital Coimbra Portugal
Department of Rheumatology University Hospital of Düsseldorf Duesseldorf Germany
EULAR Social Leagues Patients' representative Leuven Belgium
EULAR Social Leagues Patients' representative Zürich Switzerland
Institute of Rheumatology Praha Czech Republic
Women's Health Academic Centre St Thomas' Hospital London UK
Citace poskytuje Crossref.org
EULAR points to consider for the management of difficult-to-treat rheumatoid arthritis