Treatment strategy for women of child-bearing age（WoCBA）with rheumatoid arthritis
2019 Volume 31 Issue 1 Pages 7-14
Details
2019 Volume 31 Issue 1 Pages 7-14
Objective: To establish a treatment strategy for women of child-bearing age（WoCBA）with rheumatoid arthritis（RA）.
Methods: We performed a review of recommendations, guidelines, original articles, and case reports.
Result: Methotrexate should be discontinued when RA patients plan to become pregnant. Sarazosulfapyridine, azathioprine（AZA）, cyclosporine（CyA）, or tacrolimus（TAC）can be used. AZA, CyA and TAC were previously contraindicated for pregnant women in Japan, however, in July 2018 this policy changed and the drugs are no longer considered to be contraindicated. Etanercept（ETN）and certolizumab-pegol（CZP）are biologic agents that are recommended for patients with high disease activity. It was reported that CZP hardly passes through placenta and shows almost no secretion in milk; however, there is little evidence in Japan because CZP only became available in 2012 while ETN became available in 2005.
Conclusion: We must establish the treatment strategy of WoCBA in patients with RA including the usage of CZP in Japan.
