Risk factors for flare and treatment of disease flares during pregnancy in rheumatoid arthritis and axial spondyloarthritis patients

• DOI: 10.1186/s13075-017-1269-1
• Publication Date: 2017-03-20T09:23:55Z
• Authors: Stephanie van den...; Astrid Zbinden; Dominique Baeten; Peter M. Villiger; Monika Østensen; Frauke Förger
• Keywords: Discontinuation

During pregnancy, patients with rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA) can experience active disease, which might be influenced by adjustment of treatment around conception. The aim this study was to identify possible risk factors disease flares during pregnancy evaluate the effect in pregnant experiencing a flare.Pregnant RA axSpA were prospectively followed before, during, after pregnancy. Disease activity analyzed regard medication.Among 136 patients, occurred 29% 25% axSpA. In both diseases, tumor necrosis factor inhibitor (TNFi) discontinuation early identified as for Of 75 RA, 15 on TNFi discontinued at time positive test. After stopping TNFi, increased, reflected peaking C-reactive protein levels first trimester. relative flare 3.33 (95% CI 1.8-6.1). Initiation or glucocorticosteroid (GC) 60% these resulted improvement second third trimesters. comparison, without preconception period, most whom had used pregnancy-compatible antirheumatic drugs, showed mild stable before 61 axSpA, 24 aggravation trimester could observed. group 3.08 1.2-7.9). spite initiated GC 62.5% remained elevated throughout Patients period persistent high from prepregnancy until postpartum period.On basis risk-benefit analysis, stabilize prevent tailored medication including TNF inhibitors should considered beyond