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In pregnancy, the cessation of treatment response before gestational week 20 among women with RA and JIA is advantageous.
Tumor necrosis factor inhibitors (TNFi) discontinuation prior to gestational week 20 provides positive outcomes among women suffered from juvenile idiopathic arthritis (JIA) and rheumatoid arthritis (RA) and start pregnancy with the well‐controlled disease, evident from a prospective cohort study of Arthritis & Rheumatology.
A total of 490 pregnant women were selected for the analysis. The data regarding disease activity and medication were obtained before gestational week 20 and at gestational week 32. Further, unadjusted and multivariate analyses were used to validate associations between disease activity changes and the patterns of TNFi continuation or discontinuation.
Out of 490 participants, 167 did not take TNFi treatment at the time of pregnancy, 122 discontinued TNFi before gestational week 20 and 201 took TNFi beyond week 20. Disease activity at the time of enrollment was low to minimal in 72.9% of the participants. At the third trimester, the women discontinued the treatment showed no correlation with clinically significant worsening of patient-reported outcome measures and women who used treatment beyond week 20 were more expected to experience improved disease activity. As per these findings, discontinuing the treatment before gestational week 20 appears to be feasible during pregnancy.
Arthritis & Rheumatology
Discontinuing TNF-inhibitors before gestational week 20 in well-controlled rheumatoid arthritis and juvenile arthritis is not associated with a disease worsening in late pregnancy.
Frauke Förger et al.
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