Medication for treating inflammatory rheumatic disorders in pregnancy

Inflammatory rheumatic disorders is the name given to a series of autoimmune diseases that are often long-term in nature. The inflammation predominantly occurs in the musculoskeletal system, although it may also affect other organs such as the heart and kidneys. The common symptoms of these disorders include joint pain and restricted movement. Non-specific symptoms such as fatigue, fever or weight loss can also occur. During pregnancy, the symptoms of some inflammatory rheumatic disorders, such as rheumatoid arthritis, may improve. However, in patients with other inflammatory rheumatic disorders, such as systemic lupus erythematosus, the symptoms may worsen during pregnancy and there is an increased risk of complications including miscarriage, premature birth and stillbirth. During pregnancy, it is generally safe to use medication to treat inflammatory rheumatic disorders. Patients need to be careful when using medication to treat inflammatory rheumatic disorders while pregnant because not all medicines are safe to take in pregnancy.

Causes of inflammatory rheumatic disorders

There are a number of inflammatory rheumatic disorders:

• Inflammatory joint disorders, e.g. rheumatoid arthritis
• Inflammatory disorders of the spine and individual joints, e.g. ankylosing spondylitis
• Inflammatory rheumatic disorders of the blood vessels and connective tissue, e.g. systemic lupus erythematosus (SLE)

The causes of most inflammatory rheumatic disorders are unclear.

Medication for treating inflammatory rheumatic disorders during pregnancy

Inflammatory rheumatic disorders can continue to be treated using medication during pregnancy. Inflammatory rheumatic disorders can be treated using a range of different medications or active ingredients. You may have questions about how safe these medications are during pregnancy:

• Ibuprofen (Aktren, Dolormin, Dismenol), acetylsalicylic acid (Aspirin, Dolomo, Neuralgin, Godamed, Melabon, Excedrin Kopfschmerz und Migräne Headache and Migraine, Alka-Seltzer), ketoprofen (Gabrilen), naproxen (Dolormin, Naproxen InfectoPharm), diclofenac (Voltaren, Flector), oxaceprol (AHP 200 Filmtabletten film-coated tablets), aceclofenac (Beofenac), meloxicam (Mobec), nabumetone (Relifex), felbinac (ThermaCare Schmerzgel pain gel), acemetacin (Ziloxicum)
• Prednisolone (Decortin H tablets), methylprednisolone (Metypred Galen tablets)
• Methotrexate (Methotrexat Mundipharma), leflunomide (Arava tablets), hydroxychloroquine (Quensyl), sulfasalazine (Azulfidine, Pleon RA), azathioprine (Imurek), ciclosporin (Immunosporin, Sandimmun), mycophenolate (CellCept, Mowel, Myfenax)
• Adalimumab (Humira, Amgevita, Hulio, Hyrimoz, Idacio, Imraldi, Yuflyma), certolizumab (Cimzia), etanercept (Benepali, Enbrel, Erelzi, Nepexto), golimumab (Simponi), infliximab (Flixabi, Inflectra, Remicade, Remsima, Zessly), rituximab (MabThera, Rixathon, Ruxience)
• Cyclophosphamide (Endoxan)

Risks of medication for treating inflammatory rheumatic disorders during pregnancy

Taking medication to treat inflammatory rheumatic disorders during pregnancy may cause various side effects, such as an upset stomach, nausea, vomiting, drowsiness and dizziness. It is extremely important to choose the right medication to treat inflammatory rheumatic disorders during pregnancy since some medicines such as diclofenac are discouraged (contraindicated) from the 28th week of pregnancy because they may lead to serious complications for the unborn child (closure of the ductus arteriosus blood vessel, kidney damage). There are, however, some medicines that can be taken during pregnancy, making them the preferred treatment option.

Find out whether your medication for treating your inflammatory rheumatic disorder is safe during pregnancy

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