Management of Inflammatory Arthritis in pregnancy: a National Cross-Sectional Survey of Canadian rheumatologists

Abstract Background With improved therapies and management, more women with inflammatory arthritides (IA) are considering pregnancy. Our objective was to survey rheumatologists across Canada about their IA management in pregnancy to identify practice patterns and knowledge gaps. Methods We administered an online survey with questions regarding medications for IA treatment including conventional synthetic disease modifying antirheumatic drugs (csDMARDs) and biologics/small molecules in planned and unplanned pregnancies. Email invitations were sent to members of the Canadian Rheumatology Association. We calculated responses frequencies and a priori set a cut-off of ≥75% to define consensus. Results Ninety rheumatologists participated in the survey (20% participation rate); 57% have been practicing for > 10 years, 32% for ≤10 years, and 11% in training. There was consensus on discontinuation of 4 csDMARDs – cyclophosphamide (100%), leflunomide (98%), methotrexate (96%), and mycophenolate mofetil (89%) – in planned pregnancies but varied responses on when to discontinue them or what to do in unplanned pregnancies. Respondents agreed that 3 csDMARDs – azathioprine (84%), hydroxychloroquine (95%), and sulfasalazine (77%) – were safe to continue in planned and unplanned pregnancies. There was consensus with use of 4 biologics – adalimumab (81%), certolizumab (80%), etanercept (83%), and infliximab (76%) – in planned pregnancies but uncertainty on when they should be discontinued and their use in unplanned pregnancies. Conclusions This national survey shows consensus among rheumatologists on the use of some csDMARDs and biologics/small molecules in IA patients planning pregnancy but varied knowledge on when to discontinue and what to do in unplanned pregnancies.

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PID https://www.doi.org/10.6084/m9.figshare.c.4514600
PID https://www.doi.org/10.6084/m9.figshare.c.4514600.v1
URL http://dx.doi.org/10.6084/m9.figshare.c.4514600
URL http://dx.doi.org/10.6084/m9.figshare.c.4514600.v1
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Author Vera, Mary
Author Corisande Baldwin
Author Tsao, Nicole
Author Howren, Alyssa
Author Hazlewood, Glen
Author Rebić, Nevena
Author Ensworth, Stephanie
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Collected From Datacite
Hosted By figshare
Publication Date 2019-01-01
Publisher Figshare
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Language UNKNOWN
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keyword FOS: Biological sciences
keyword FOS: Clinical medicine
system:type other
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Source https://science-innovation-policy.openaire.eu/search/other?orpId=dedup_wf_001::96af44b3b377a3ade3edfd566a7751aa
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Last Updated 20 December 2020, 02:21 (CET)
Created 20 December 2020, 02:21 (CET)