Prescribing immunosuppressive and comorbidity drugs during conception, pregnancy and breastfeeding - the updated British Society for Rheumatology guideline scope
Ian Giles, Rachel Allen, Hafsah Amanji, Coziana Ciurtin, Elizabeth Clarke, Maud van de Venne, Hope De Vere, Sarah Dyball, Julia D Flint, Margreta Frishman, Mary Gayed, Caroline Gordon, Latika Gupta, Kenneth Hodson, Jonathan Richardson, Victoria Hoskins, Dina Husum, Issrah Jawad, Munther Andrawes Khamashta, Max Lyon, Elizabeth Mabey, Victoria Male, Rebecca McCord, Louise Moore, Christie Parfitt, Helen Richards, Mark D Russell, Nadia Sarween, Karen Schreiber, Naz Senvar, Iona Thorne, Sofia Tosounidou, Louise Warburton, David Williams, Chee-Seng Yee,Lay Summary
What does this mean for patients?
Rheumatic and musculoskeletal diseases are a diverse group of diseases that commonly affect the joints but can affect any organ of the body. These diseases can affect people who are planning pregnancy, are already pregnant or have recently delivered a baby. It is important to control these diseases with medicines because inadequately treated active disease can increase the risk of problems during pregnancy and after the baby is born. People are usually advised to plan pregnancy when their disease is well-controlled and they are taking medicines that are safe to continue during pregnancy. The British Society for Rheumatology published guidance on this topic in 2016 and updated it in 2023. Since then, more information has become available about the safety of medicines used to treat rheumatic diseases in people planning to have a child, as well as during pregnancy and breastfeeding This update will review the latest evidence on drug use in pregnancy. It will also consider people with childhood-onset rheumatic disease. This is important because unplanned pregnancy is common in teenagers, and care needs may be different for people whose disease began in childhood. The guidance will be developed by people with lived experience, as well as specialists in both childhood and adult rheumatic disease.