Date: Tuesday, October 23, 2018
Session Title: Reproductive Issues in Rheumatic Disorders Poster
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Previous reports revealed that it was difficult for rheumatoid arthritis (RA) patients to conceive1). Age, nulliparity, disease activity, NSAIDs, corticosteroid was known as the risk factors of subfertilities2). On the other hand, anti-TNF inhibitor (adalimumab) combined with or without immunoglobulin was reported to improve the outcome of infertility treatment3). We examine the impact of biologic (bDMARDs) treatment on conception and delivery complicated with rheumatoid arthritis.
Methods: We investigated 25 cases (15cases which had continued bDMARDs until conceiving; group A, 10 cases which discontinued both bDMARDs and conventional synthetic DMARDs at the time of hope to conceive; group B) retrospectively on the period of conception, the disease activity of RA and perinatal outcomes.
Results: Between two groups, disease activities at the time of planning for pregnancy and conceiving were no significant difference. The average period of conception was 6.14}3.80 months in group A, which was shorter than 11.89}6.21 months in group B (P=0.024, figure 1). The average birth weight of the babies in group B was 2446.57}375.73, significantly smaller than 2956.60}506.86 in group A (P=0.039, figure 2). However, the average gestational week was 38.58}1.16 in group A, which was not different from 38.00}1.41 in group B. There was no significant difference on the rate of abortion, preterm birth, LFD (light for date), premature rupture of membrane between two groups. In the cases of preterm birth and LFD babies, the average dose of corticosteroid during pregnancy was significantly higher than those of full-term birth and no LFD babies (P=0.028, 0.013 respectively).
Conclusion: In RA patients who hope pregnancy, continuing bDMARDs at the time of pregnancy had the advantage in conceiving earlier. Using bDMARDs before pregnancy has an influence on perinatal complications and development of their babies.
Reference: 1) Jawaheer D et al. Arthritis Rheum. 2011 Jun;63(6):1517-21
2) Brouwer J et al. Ann Rheum Dis. 2015;74:1836-184
3) Winger EE, et al. Am J Reprod Immunol. 2009 Feb;61(2):113-20
To cite this abstract in AMA style:Shimada H, Miyagi T, Kato M, Wakiya R, Nakashima S, Kameda T, Dobashi H. The Impact of Biologic Treatment for Rheumatoid Arthritis Patients Who Hope to Conceive [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/the-impact-of-biologic-treatment-for-rheumatoid-arthritis-patients-who-hope-to-conceive/. Accessed March 21, 2023.
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