Disease Activity During Pregnancy in Patients with Rheumatoid Arthritis or Spondyloarthritis: Results from the Multicentre Prospective GR2 Study

Marion couderc¹, celine lambert², sabrina hamroun³, denis gallot⁴, Nathalie Costedoat-chalumeau⁵, Laure Gossec⁶, Gaëlle Guettrot-Imbert⁷, Veronique LE GUERN⁷, Christophe Richez⁸, MArtin Soubrier⁹ and Anna Molto¹⁰, ¹CHU de Clermont-Ferrand, Clermont-Ferrand, ²chu clermont ferrand, clermont ferrand, France, ³Rheumatology Department - Cochin Hospital, Paris, France, ⁴Department of Obstetrics, CHU Clermont-ferrand, Clermont-Ferrand, Auvergne, France, ⁵University Paris Cité, Paris, France, ⁶Sorbonne Université, Paris, France, ⁷Cochin Hospital, Paris, France, ⁸Université de Bordeaux, Bordeaux, France, ⁹Gabriel-Montpied Hospital, Clermont-ferrand, France, ¹⁰Groupe Hospitalier Cochin, AP-HP, Paris, France

Meeting: ACR Convergence 2024

Keywords: Disease Activity, Disease-Modifying Antirheumatic Drugs (Dmards), pregnancy, rheumatoid arthritis, spondyloarthritis

Session Information

Date: Saturday, November 16, 2024

Title: Reproductive Issues in Rheumatic Disorders Poster

Session Type: Poster Session A

Session Time: 10:30AM-12:30PM

Background/Purpose: Pregnancy may have a beneficial effect on disease activity in rheumatoid arthritis (RA) but the evidence is more conflicting in spondyloarthritis (SpA). The aim of this study was to analyse disease activity and relapse during pregnancy in patients with RA and SpA.

Methods: Consecutive pregnant women with RA or SpA were enrolled in this French multicentre observational cohort from 2014 to 2022. Women who had at least two prenatal visits (including one in the first trimester) were included in the analysis. Disease relapse was defined as treatment intensification (initiation or switch of a DMARD) or increase in disease activity scores (DAS28-CRP for RA patients; ASDAS-CRP and/or BASDAI for SpA patients).

Results: Of the 124 pregnant women included, 53 had RA and 71 had SpA. A total of 18 (35%) RA and 44 (62%) SPA received a TNF inhibitor during pregnancy. At the group level, disease activity indexes remained stable in the 1^st, 2^nd and 3^rd trimesters. Disease relapse during pregnancy occurred in 17 (32%) RA patients and 28 (39%) SpA patients, among whom 30 (24%) requiring a treatment intensification. In multivariable analysis, factors associated with disease relapse were nulliparity (odds ratio, OR: 6.5, 95%CI: 1.1-37.9) and a disease flare in the 12 months prior to conception (OR: 8.2, 95%CI: 1.6-42.7) for RA patients, and a history of bDMARD use (OR: 5.4, 95%CI: 1.1 to 27.3) for SpA patients.

Disease activity scores were stable during pregnancy in RA and SpA patients but nearly a quarter of women required major changes to their treatment. Close monitoring of disease activity in pregnant women with RA or SpA is necessary, particularly for those with unstable rheumatism before conception for RA patients, and those who ever received bDMARDS for SpA patients.

Conclusion: Disease activity scores were stable during pregnancy in RA and SpA patients but nearly a quarter of women required major changes to their treatment. Close monitoring of disease activity in pregnant women with RA or SpA is necessary, particularly for those with unstable rheumatism before conception for RA patients, and those who ever received bDMARDS for SpA patients.

Disclosures: M. couderc: None; c. lambert: None; s. hamroun: None; d. gallot: None; N. Costedoat-chalumeau: Bristol-Myers Squibb(BMS), 1; L. Gossec: AbbVie, 2, 5, Amgen, 2, Biogen, 5, Bristol-Myers Squibb (BMS), 2, Celltrion, 2, Eli Lilly, 2, 5, Galapagos, 2, Janssen, 2, MSD, 2, Novartis, 2, 5, Pfizer, 2, Sandoz, 2, UCB, 2, 5; G. Guettrot-Imbert: None; V. LE GUERN: None; C. Richez: Abbvie, Astra Zeneca, BMS, GSK, Lilly, Novartis, Pfizer, UCB, 6, Lilly and Biogen, 5; M. Soubrier: None; A. Molto: AbbVie, 2, 5, MSD, 2, 5, Pfizer, 2, 5, UCB, 2, 5.

To cite this abstract in AMA style:

couderc M, lambert c, hamroun s, gallot d, Costedoat-chalumeau N, Gossec L, Guettrot-Imbert G, LE GUERN V, Richez C, Soubrier M, Molto A. Disease Activity During Pregnancy in Patients with Rheumatoid Arthritis or Spondyloarthritis: Results from the Multicentre Prospective GR2 Study [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/disease-activity-during-pregnancy-in-patients-with-rheumatoid-arthritis-or-spondyloarthritis-results-from-the-multicentre-prospective-gr2-study/. Accessed .

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