RA: Stopping bDMARD early in pregnancy increases risk for disease flare and preterm delivery

Key clinical point: Discontinuation of biologic disease-modifying antirheumatic drugs (bDMARD) upon testing positive for pregnancy is associated with and a major risk factor for disease flare during pregnancy in a large proportion of women with rheumatoid arthritis (RA) and good disease control prior to conception.

Major finding: Overall, flare was reported by 37% of patients during pregnancy and was associated with discontinuing bDMARD upon testing positive for pregnancy (odds ratio [OR] 2.857; P  =  .034) and previous use of >1 bDMARD (OR 4.1; P  =  .019). Patients with vs without disease flare during pregnancy were more likely to report preterm delivery (27% vs 7%; OR 4.625; P  =  .034).

Study details: This study analyzed the retrospectively collected data of 73 pregnancies in 63 women with RA and good disease control during conception who were prospectively followed through their pregnancies.

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Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Gerardi MC et al. Stopping bDMARDs at the beginning of pregnancy is associated with disease flares and preterm delivery in women with rheumatoid arthritis. Front Pharmacol. 2022 (Aug 3). Doi: 10.3389/fphar.2022.887462