Management of early aggressive rheumatoid arthritis during pregnancy and lactation.
This survey outlines the problems of drug therapy in women with early aggressive rheumatoid arthritis (RA) who desire children, are pregnant, or are lactating. Solutions for treatment that benefit the mother and do not harm the fetus or the breast-fed child are discussed. The most effective immunosuppressive drugs alone or in combination are contraindicated during pregnancy and, to a lesser degree, also during lactation. Judicious timing of therapy is therefore necessary, aiming at fast remission of symptoms with the most effective therapy and maintaining quiescent disease with drugs compatible with pregnancy or lactation.
Ostensen
Monika
M
Department of Rheumatology, and Clinical Immunology and Allergy, University Hospital, CH-3010 Bern, Switzerland. monika.oestensen@insel.ch
D000818:Animals; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D019468:Disease Management; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D007231:Infant, Newborn; D007774:Lactation / Q000187:drug effects / Q000378:metabolism; D011247:Pregnancy; D011248:Pregnancy Complications / Q000378:metabolism / Q000628:therapy*; D013997:Time Factors
D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents