Survey of antimalarial use in lupus pregnancy and lactation.
OBJECTIVE
To obtain the experience of selected experts in the use of antimalarial drugs (AM) in pregnancy and lactation in systemic lupus erythematosus.


METHODS
Seventy-eight lupus experts identified from North America and UK were mailed a 19 question survey regarding their experience using AM in pregnancy and lactation.


RESULTS
The 52 (67%) respondents with usable questionnaires treated a median of 75 lupus patients/year, including 4-5 lupus pregnancies/year. Thirty-five (69%) continued AM sometimes, often, or always during pregnancy. Continuing AM increased with the number of pregnant lupus patients seen (p < 0.01). None reported having seen any fetal toxicity with AM use, and pregnancy was never terminated because of AM, other than at patient insistence (n = 1). Postpartum, 29 (63%) continued AM and advised breast-feeding. Responses were consistent among North American and UK experts.


CONCLUSIONS
The majority of lupus experts continue AM during pregnancy. This was particularly true for those who treated a larger number of pregnant lupus patients per year. The majority advise breast-feeding and continue AM postpartum. These practices are supported by the limited literature available.
Al-Herz
Adeeba
A
Arthritis Research Centre of Canada and Department of Medicine, University of British Columbia, Vancouver.
Schulzer
Michael
M
Esdaile
John M
JM
D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use*; D005104:Expert Testimony; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007774:Lactation; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy*; D016239:MEDLINE; D008297:Male; D008875:Middle Aged; D009656:North America; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011256:Pregnancy Outcome; D006113:United Kingdom
D000962:Antimalarials