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Gebelikte Romatoid Artrit Tedavisi: Derleme

Year 2013, Volume: 5 Issue: 2, 62 - 69, 01.08.2013

Bozkurt M Demet Uçar

Abstract

Yetişkinlerin yaklaşık %1-2’sini etkileyen Romatoid artrit (RA), kadınlarda erkeklere oranla daha sık görülür ve bu kadınların bir kısmı da doğurganlık yaşlarındadır. RA’lı hastaların çoğunda gebelikte hastalık aktivitesi azalırken, az bir kısmında ise semptomlar kötüleşir. Gebelikte RA tedavisi zordur. Tedavisinde kullanılan bazı ilaçların gebelikte güvenli olduğunu gösteren yeterli çalışma mevcut değildir. RA’lı hastaların gebelik ve emzirme dönemi tedavisi dikkatli yapılmalıdır. Bu dönemlerde kullanılacak ilaçların güvenliği açısından yeni çalışmalara ihtiyaç vardır

Keywords

Romatoid Artrit Gebelik Emzirme Tedavi

References

  • Dugowson CE, Koepsell TD, Voigt LF, Bley L, Nelson JL, Daling JR. Rheumatoid arthritis in women. Incidence rates in group health cooperative, Seattle, Washington, 1987-1989. Arthritis Rheum. 1991;34(12):1502-7.
  • Ostensen M, Aune B, Husby G. Effect of pregnancy and hormonal changes on the activity of rheumatoid arthritis. Scand J Rheumatol. 1983;12(2):69-72.
  • Pope RM, Yoshinoya S, Rutstein J, Persellin RH. Effect of pregnancy on immune complexes and rheumatoid factors in patients with rheumatoid arthritis. Am J Med. 1983;74(6):973-9.
  • Nelson JL, Ostensen M. Pregnancy and rheumatoid arthritis. Rheum Dis Clin North Am. 1997;23(1):195- 212.
  • Ostensen M, Forger F, Nelson JL, Schuhmacher A, Hebisch G, Villiger PM. Pregnancy in patients with rheumatic disease: anti-inflammatory cytokines increase in pregnancy and decrease post partum. Ann Rheum Dis. 2005;64(6):839-44.
  • Masi AT, Feigenbaum SL, Chatterton RT. Hormonal and pregnancy relationships to rheumatoid arthritis: convergent effects with immunologic and microvascular systems. Semin Arthritis Rheum. 1995;25(1):1-27.
  • Liang MH, Karlson EW. Female hormone therapy and the risk of developing or exacerbating systemic lupus erythematosus or rheumatoid arthritis. Proc Assoc Am Physicians. 1996;108(1):25-8.
  • Drossaers-Bakker KW, Zwinderman AH, van Zeben D, Breedveld FC, Hazes JM. Pregnancy and oral contraceptive use do not significantly influence outcome in long term rheumatoid arthritis. Ann Rheum Dis. 2002;61(5):405-8.
  • Klipple GL, Cecere FA. Rheumatoid arthritis and pregnancy. Rheum Dis Clin North Am. 1989;15(2):213- 39.
  • Silman A, Kay A, Brennan P. Timing of pregnancy in relation to the onset of rheumatoid arthritis. Arthritis Rheum. 1992;35(2):152-5.
  • Oka M. Effect of pregnancy on the onset and course of rheumatoid arthritis. Ann Rheum Dis. 1953;12(3):227-9.
  • Kaplan D, Diamond H. Rheumatoid Arthritis and Pregnancy. Clin Obstet Gynecol. 1965;17:286-303.
  • Spector TD, Silman AJ. Is poor pregnancy outcome a risk factor in rheumatoid arthritis? Ann Rheum Dis. 1990;49(1):12-4.
  • de Man YA, Hazes JM, van der Heide H, et al. Association of higher rheumatoid arthritis disease activity during pregnancy with lower birth weight: results of a national prospective study. Arthritis Rheum. 2009;60(11):3196-206.
  • Barrett JH, Brennan P, Fiddler M, Silman A. Breast-feeding and postpartum relapse in women with rheumatoid and inflammatory arthritis. Arthritis Rheum. 2000;43(5):1010-5.
  • Karlson EW, Mandl LA, Hankinson SE, Grodstein F. Do breast-feeding and other reproductive factors influence future risk of rheumatoid arthritis? Results from the Nurses' Health Study. Arthritis Rheum. 2004;50(11):3458-67.
  • Deighton CM, Sykes H, Walker DJ. Rheumatoid arthritis, HLA identity, and age at menarche. Ann Rheum Dis. 1993;52(5):322-6.
  • Silman AJ. Parity status and the development of rheumatoid arthritis. Am J Reprod Immunol. 1992;28(3- 4):228-30.
  • Parke A, West B. Hydroxychloroquine in pregnant patients with systemic lupus erythematosus. J Rheumatol. 1996;23(10):1715-8.
  • Clowse ME, Magder L, Witter F, Petri M. Hydroxychloroquine in lupus pregnancy. Arthritis Rheum. 2006;54(11):3640-7.
  • Buchanan NM, Toubi E, Khamashta MA, Lima F, Kerslake S, Hughes GR. Hydroxychloroquine and lupus pregnancy: review of a series of 36 cases. Ann Rheum Dis. 1996;55(7):486-8.
  • Costedoat-Chalumeau N, Amoura Z, Duhaut P, et al. Safety of hydroxychloroquine in pregnant patients with connective tissue diseases: a study of one hundred thirty-three cases compared with a control group. Arthritis Rheum. 2003;48(11):3207-11.
  • Canadian Consensus Conference on hydroxychloroquine. J Rheumatol. 2000;27(12):2919-21.
  • Jarnerot G, Into-Malmberg MB, Esbjorner E. Placental transfer of sulphasalazine and sulphapyridine and some of its metabolites. Scand J Gastroenterol. 1981;16(5):693-7.
  • Mogadam M, Dobbins WO, 3rd, Korelitz BI, Ahmed SW. Pregnancy in inflammatory bowel disease: effect of sulfasalazine and corticosteroids on fetal outcome. Gastroenterology. 1981;80(1):72-6.
  • Toovey S, Hudson E, Hendry WF, Levi AJ. Sulphasalazine and male infertility: reversibility and possible mechanism. Gut. 1981;22(6):445-51.
  • Branski D, Kerem E, Gross-Kieselstein E, Hurvitz H, Litt R, Abrahamov A. Bloody diarrhea--a possible complication of sulfasalazine transferred through human breast milk. J Pediatr Gastroenterol Nutr. 1986;5(2):316-7.
  • Ostensen M, Khamashta M, Lockshin M, et al. Anti-inflammatory and immunosuppressive drugs and reproduction. Arthritis Res Ther. 2006;8(3):209.
  • Kozer E, Nikfar S, Costei A, Boskovic R, Nulman I, Koren G. Aspirin consumption during the first trimester of pregnancy and congenital anomalies: a meta-analysis. Am J Obstet Gynecol. 2002;187(6):1623- 30.
  • Koren G, Florescu A, Costei AM, Boskovic R, Moretti ME. Nonsteroidal antiinflammatory drugs during third trimester and the risk of premature closure of the ductus arteriosus: a meta-analysis. Ann Pharmacother. 2006 May;40(5):824-9.
  • Askie LM, Duley L, Henderson-Smart DJ, Stewart LA. Antiplatelet agents for prevention of pre-eclampsia: a meta-analysis of individual patient data. Lancet. 2007;369(9575):1791-8.
  • Ostensen M, Ramsey-Goldman R. Treatment of inflammatory rheumatic disorders in pregnancy: what are the safest treatment options? Drug Saf. 1998;19(5):389-410.
  • Beitins IZ, Bayard F, Ances IG, Kowarski A, Migeon CJ. The transplacental passage of prednisone and prednisolone in pregnancy near term. J Pediatr. 1972;81(5):936-45.
  • Carmichael SL, Shaw GM. Maternal corticosteroid use and risk of selected congenital anomalies. Am J Med Genet. 1999;86(3):242-4.
  • Lockwood CJ, Radunovic N, Nastic D, Petkovic S, Aigner S, Berkowitz GS. Corticotropin-releasing hormone and related pituitary-adrenal axis hormones in fetal and maternal blood during the second half of pregnancy. J Perinat Med. 1996;24(3):243-51.
  • Armenti VT, Ahlswede KM, Ahlswede BA, Jarrell BE, Moritz MJ, Burke JF. National transplantation Pregnancy Registry--outcomes of 154 pregnancies in cyclosporine-treated female kidney transplant recipients. Transplantation. 1994;57(4):502-6.
  • Norgard B, Pedersen L, Christensen LA, Sorensen HT. Therapeutic drug use in women with Crohn's disease and birth outcomes: a Danish nationwide cohort study. Am J Gastroenterol. 2007;102(7):1406-13.
  • Roux CH, Brocq O, Breuil V, Albert C, Euller-Ziegler L. Pregnancy in rheumatology patients exposed to anti-tumour necrosis factor (TNF)-alpha therapy. Rheumatology (Oxford). 2007;46(4):695-8.
  • Ali YM, Kuriya B, Orozco C, Cush JJ, Keystone EC. Can tumor necrosis factor inhibitors be safely used in pregnancy? J Rheumatol. 2010;37(1):9-17.
  • Said TM, Agarwal A, Falcone T, Sharma RK, Bedaiwy MA, Li L. Infliximab may reverse the toxic effects induced by tumor necrosis factor alpha in human spermatozoa: an in vitro model. Fertil Steril. 2005;83(6):1665-73.
  • Reznikoff-Etievant MF, de Lachaux Y, Marpeau L, Courouce A. Intravenous immunoglobulins and hepatitis C transmission in healthy pregnant women. Lancet. 1992;340(8825):986.
  • Backman L, Brandt I, Appelkvist EL, Dallner G. Tissue and subcellular localizations of 3H-cyclosporine A in mice. Pharmacol Toxicol. 1988;62(2):110-7.
  • Bar Oz B, Hackman R, Einarson T, Koren G. Pregnancy outcome after cyclosporine therapy during pregnancy: a meta-analysis. Transplantation. 2001;71(8):1051-5.
  • Kainz A, Harabacz I, Cowlrick IS, Gadgil SD, Hagiwara D. Review of the course and outcome of 100 pregnancies in 84 women treated with tacrolimus. Transplantation. 2000;70(12):1718-21.
  • Venkataramanan R, Koneru B, Wang CC, Burckart GJ, Caritis SN, Starzl TE. Cyclosporine and its metabolites in mother and baby. Transplantation. 1988;46(3):468-9.
  • Di Paolo S, Monno R, Stallone G, et al. Placental imbalance of vasoactive factors does not affect pregnancy outcome in patients treated with Cyclosporine A after transplantation. Am J Kidney Dis. 2002;39(4):776-83.
  • Kart Koseoglu H, Yucel AE, Kunefeci G, Ozdemir FN, Duran H. Cyclophosphamide therapy in a serious case of lupus nephritis during pregnancy. Lupus. 2001;10(11):818-20.
  • Skalko RG, Gold MP. Teratogenicity of methotrexate in mice. Teratology. 1974;9(2):159-63.
  • Buckley LM, Bullaboy CA, Leichtman L, Marquez M. Multiple congenital anomalies associated with weekly low-dose methotrexate treatment of the mother. Arthritis Rheum. 1997;40(5):971-3.
  • Chambers CD, Johnson DL, Robinson LK, et al. Birth outcomes in women who have taken leflunomide during pregnancy. Arthritis Rheum. 2010;62(5):1494-503.
  • Kimby E, Sverrisdottir A, Elinder G. Safety of rituximab therapy during the first trimester of pregnancy: a case history. Eur J Haematol. 2004;72(4):292-5.

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Year 2013, Volume: 5 Issue: 2, 62 - 69, 01.08.2013

Bozkurt M Demet Uçar

Abstract

Rheumatoid arthritis (RA) affects approximately 1-2% of adults, it is more common in women than men, and some of these women are in the reproductive age. In most pregnant women with RA, disease activity is reduced but, in a minority of them symptoms gets worse. Management of RA during pregnancy is difficult. Treatment of patients with RA during pregnancy and lactation should be carefully carried out. No sufficient studies are available about safety of some drugs for management of RA in pregnancy. Further studies are needed to investigate the safety of drugs that used for RA in pregnancy

Keywords

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References

  • Dugowson CE, Koepsell TD, Voigt LF, Bley L, Nelson JL, Daling JR. Rheumatoid arthritis in women. Incidence rates in group health cooperative, Seattle, Washington, 1987-1989. Arthritis Rheum. 1991;34(12):1502-7.
  • Ostensen M, Aune B, Husby G. Effect of pregnancy and hormonal changes on the activity of rheumatoid arthritis. Scand J Rheumatol. 1983;12(2):69-72.
  • Pope RM, Yoshinoya S, Rutstein J, Persellin RH. Effect of pregnancy on immune complexes and rheumatoid factors in patients with rheumatoid arthritis. Am J Med. 1983;74(6):973-9.
  • Nelson JL, Ostensen M. Pregnancy and rheumatoid arthritis. Rheum Dis Clin North Am. 1997;23(1):195- 212.
  • Ostensen M, Forger F, Nelson JL, Schuhmacher A, Hebisch G, Villiger PM. Pregnancy in patients with rheumatic disease: anti-inflammatory cytokines increase in pregnancy and decrease post partum. Ann Rheum Dis. 2005;64(6):839-44.
  • Masi AT, Feigenbaum SL, Chatterton RT. Hormonal and pregnancy relationships to rheumatoid arthritis: convergent effects with immunologic and microvascular systems. Semin Arthritis Rheum. 1995;25(1):1-27.
  • Liang MH, Karlson EW. Female hormone therapy and the risk of developing or exacerbating systemic lupus erythematosus or rheumatoid arthritis. Proc Assoc Am Physicians. 1996;108(1):25-8.
  • Drossaers-Bakker KW, Zwinderman AH, van Zeben D, Breedveld FC, Hazes JM. Pregnancy and oral contraceptive use do not significantly influence outcome in long term rheumatoid arthritis. Ann Rheum Dis. 2002;61(5):405-8.
  • Klipple GL, Cecere FA. Rheumatoid arthritis and pregnancy. Rheum Dis Clin North Am. 1989;15(2):213- 39.
  • Silman A, Kay A, Brennan P. Timing of pregnancy in relation to the onset of rheumatoid arthritis. Arthritis Rheum. 1992;35(2):152-5.
  • Oka M. Effect of pregnancy on the onset and course of rheumatoid arthritis. Ann Rheum Dis. 1953;12(3):227-9.
  • Kaplan D, Diamond H. Rheumatoid Arthritis and Pregnancy. Clin Obstet Gynecol. 1965;17:286-303.
  • Spector TD, Silman AJ. Is poor pregnancy outcome a risk factor in rheumatoid arthritis? Ann Rheum Dis. 1990;49(1):12-4.
  • de Man YA, Hazes JM, van der Heide H, et al. Association of higher rheumatoid arthritis disease activity during pregnancy with lower birth weight: results of a national prospective study. Arthritis Rheum. 2009;60(11):3196-206.
  • Barrett JH, Brennan P, Fiddler M, Silman A. Breast-feeding and postpartum relapse in women with rheumatoid and inflammatory arthritis. Arthritis Rheum. 2000;43(5):1010-5.
  • Karlson EW, Mandl LA, Hankinson SE, Grodstein F. Do breast-feeding and other reproductive factors influence future risk of rheumatoid arthritis? Results from the Nurses' Health Study. Arthritis Rheum. 2004;50(11):3458-67.
  • Deighton CM, Sykes H, Walker DJ. Rheumatoid arthritis, HLA identity, and age at menarche. Ann Rheum Dis. 1993;52(5):322-6.
  • Silman AJ. Parity status and the development of rheumatoid arthritis. Am J Reprod Immunol. 1992;28(3- 4):228-30.
  • Parke A, West B. Hydroxychloroquine in pregnant patients with systemic lupus erythematosus. J Rheumatol. 1996;23(10):1715-8.
  • Clowse ME, Magder L, Witter F, Petri M. Hydroxychloroquine in lupus pregnancy. Arthritis Rheum. 2006;54(11):3640-7.
  • Buchanan NM, Toubi E, Khamashta MA, Lima F, Kerslake S, Hughes GR. Hydroxychloroquine and lupus pregnancy: review of a series of 36 cases. Ann Rheum Dis. 1996;55(7):486-8.
  • Costedoat-Chalumeau N, Amoura Z, Duhaut P, et al. Safety of hydroxychloroquine in pregnant patients with connective tissue diseases: a study of one hundred thirty-three cases compared with a control group. Arthritis Rheum. 2003;48(11):3207-11.
  • Canadian Consensus Conference on hydroxychloroquine. J Rheumatol. 2000;27(12):2919-21.
  • Jarnerot G, Into-Malmberg MB, Esbjorner E. Placental transfer of sulphasalazine and sulphapyridine and some of its metabolites. Scand J Gastroenterol. 1981;16(5):693-7.
  • Mogadam M, Dobbins WO, 3rd, Korelitz BI, Ahmed SW. Pregnancy in inflammatory bowel disease: effect of sulfasalazine and corticosteroids on fetal outcome. Gastroenterology. 1981;80(1):72-6.
  • Toovey S, Hudson E, Hendry WF, Levi AJ. Sulphasalazine and male infertility: reversibility and possible mechanism. Gut. 1981;22(6):445-51.
  • Branski D, Kerem E, Gross-Kieselstein E, Hurvitz H, Litt R, Abrahamov A. Bloody diarrhea--a possible complication of sulfasalazine transferred through human breast milk. J Pediatr Gastroenterol Nutr. 1986;5(2):316-7.
  • Ostensen M, Khamashta M, Lockshin M, et al. Anti-inflammatory and immunosuppressive drugs and reproduction. Arthritis Res Ther. 2006;8(3):209.
  • Kozer E, Nikfar S, Costei A, Boskovic R, Nulman I, Koren G. Aspirin consumption during the first trimester of pregnancy and congenital anomalies: a meta-analysis. Am J Obstet Gynecol. 2002;187(6):1623- 30.
  • Koren G, Florescu A, Costei AM, Boskovic R, Moretti ME. Nonsteroidal antiinflammatory drugs during third trimester and the risk of premature closure of the ductus arteriosus: a meta-analysis. Ann Pharmacother. 2006 May;40(5):824-9.
  • Askie LM, Duley L, Henderson-Smart DJ, Stewart LA. Antiplatelet agents for prevention of pre-eclampsia: a meta-analysis of individual patient data. Lancet. 2007;369(9575):1791-8.
  • Ostensen M, Ramsey-Goldman R. Treatment of inflammatory rheumatic disorders in pregnancy: what are the safest treatment options? Drug Saf. 1998;19(5):389-410.
  • Beitins IZ, Bayard F, Ances IG, Kowarski A, Migeon CJ. The transplacental passage of prednisone and prednisolone in pregnancy near term. J Pediatr. 1972;81(5):936-45.
  • Carmichael SL, Shaw GM. Maternal corticosteroid use and risk of selected congenital anomalies. Am J Med Genet. 1999;86(3):242-4.
  • Lockwood CJ, Radunovic N, Nastic D, Petkovic S, Aigner S, Berkowitz GS. Corticotropin-releasing hormone and related pituitary-adrenal axis hormones in fetal and maternal blood during the second half of pregnancy. J Perinat Med. 1996;24(3):243-51.
  • Armenti VT, Ahlswede KM, Ahlswede BA, Jarrell BE, Moritz MJ, Burke JF. National transplantation Pregnancy Registry--outcomes of 154 pregnancies in cyclosporine-treated female kidney transplant recipients. Transplantation. 1994;57(4):502-6.
  • Norgard B, Pedersen L, Christensen LA, Sorensen HT. Therapeutic drug use in women with Crohn's disease and birth outcomes: a Danish nationwide cohort study. Am J Gastroenterol. 2007;102(7):1406-13.
  • Roux CH, Brocq O, Breuil V, Albert C, Euller-Ziegler L. Pregnancy in rheumatology patients exposed to anti-tumour necrosis factor (TNF)-alpha therapy. Rheumatology (Oxford). 2007;46(4):695-8.
  • Ali YM, Kuriya B, Orozco C, Cush JJ, Keystone EC. Can tumor necrosis factor inhibitors be safely used in pregnancy? J Rheumatol. 2010;37(1):9-17.
  • Said TM, Agarwal A, Falcone T, Sharma RK, Bedaiwy MA, Li L. Infliximab may reverse the toxic effects induced by tumor necrosis factor alpha in human spermatozoa: an in vitro model. Fertil Steril. 2005;83(6):1665-73.
  • Reznikoff-Etievant MF, de Lachaux Y, Marpeau L, Courouce A. Intravenous immunoglobulins and hepatitis C transmission in healthy pregnant women. Lancet. 1992;340(8825):986.
  • Backman L, Brandt I, Appelkvist EL, Dallner G. Tissue and subcellular localizations of 3H-cyclosporine A in mice. Pharmacol Toxicol. 1988;62(2):110-7.
  • Bar Oz B, Hackman R, Einarson T, Koren G. Pregnancy outcome after cyclosporine therapy during pregnancy: a meta-analysis. Transplantation. 2001;71(8):1051-5.
  • Kainz A, Harabacz I, Cowlrick IS, Gadgil SD, Hagiwara D. Review of the course and outcome of 100 pregnancies in 84 women treated with tacrolimus. Transplantation. 2000;70(12):1718-21.
  • Venkataramanan R, Koneru B, Wang CC, Burckart GJ, Caritis SN, Starzl TE. Cyclosporine and its metabolites in mother and baby. Transplantation. 1988;46(3):468-9.
  • Di Paolo S, Monno R, Stallone G, et al. Placental imbalance of vasoactive factors does not affect pregnancy outcome in patients treated with Cyclosporine A after transplantation. Am J Kidney Dis. 2002;39(4):776-83.
  • Kart Koseoglu H, Yucel AE, Kunefeci G, Ozdemir FN, Duran H. Cyclophosphamide therapy in a serious case of lupus nephritis during pregnancy. Lupus. 2001;10(11):818-20.
  • Skalko RG, Gold MP. Teratogenicity of methotrexate in mice. Teratology. 1974;9(2):159-63.
  • Buckley LM, Bullaboy CA, Leichtman L, Marquez M. Multiple congenital anomalies associated with weekly low-dose methotrexate treatment of the mother. Arthritis Rheum. 1997;40(5):971-3.
  • Chambers CD, Johnson DL, Robinson LK, et al. Birth outcomes in women who have taken leflunomide during pregnancy. Arthritis Rheum. 2010;62(5):1494-503.
  • Kimby E, Sverrisdottir A, Elinder G. Safety of rituximab therapy during the first trimester of pregnancy: a case history. Eur J Haematol. 2004;72(4):292-5.
There are 51 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Bozkurt M This is me

Demet Uçar This is me

Publication Date August 1, 2013
Published in Issue Year 2013 Volume: 5 Issue: 2

Cite

APA M, B., & Uçar, D. (2013). Gebelikte Romatoid Artrit Tedavisi: Derleme. Konuralp Medical Journal, 5(2), 62-69.
AMA M B, Uçar D. Gebelikte Romatoid Artrit Tedavisi: Derleme. Konuralp Medical Journal. August 2013;5(2):62-69.
Chicago M, Bozkurt, and Demet Uçar. “Gebelikte Romatoid Artrit Tedavisi: Derleme”. Konuralp Medical Journal 5, no. 2 (August 2013): 62-69.
EndNote M B, Uçar D (August 1, 2013) Gebelikte Romatoid Artrit Tedavisi: Derleme. Konuralp Medical Journal 5 2 62–69.
IEEE B. M and D. Uçar, “Gebelikte Romatoid Artrit Tedavisi: Derleme”, Konuralp Medical Journal, vol. 5, no. 2, pp. 62–69, 2013.
ISNAD M, Bozkurt - Uçar, Demet. “Gebelikte Romatoid Artrit Tedavisi: Derleme”. Konuralp Medical Journal 5/2 (August 2013), 62-69.
JAMA M B, Uçar D. Gebelikte Romatoid Artrit Tedavisi: Derleme. Konuralp Medical Journal. 2013;5:62–69.
MLA M, Bozkurt and Demet Uçar. “Gebelikte Romatoid Artrit Tedavisi: Derleme”. Konuralp Medical Journal, vol. 5, no. 2, 2013, pp. 62-69.
Vancouver M B, Uçar D. Gebelikte Romatoid Artrit Tedavisi: Derleme. Konuralp Medical Journal. 2013;5(2):62-9.