Pregnancy with Rheumatoid arthritis- anti- TNF agents

YASER M. ALI & colleagues recently analysed the available data on the safety of TNF-blockers in pregnancy. They analysed the data from multiple registries of Rheumatoid arthritis as well as inflammatory bowel disease, & the various case reports.

The study showed that cases of fetal anomalies with TNF-blockers are rare. The incidence is much lower than the 3% rate of fetal anomalies seen in general population.

Ideally, pregnancy with RA should be planned when the disease activity is well controlled. One should be doing well on Sulphasalazine or without any drug.

However, in case of pregnancy with active rheumatoid arthritis while on TNF-blockers, these medicines may be continued if the risk of disease activity flare is high, in consultation with the Rheumatologist, with due consideration of the possible albeit low risk.

Can tumor necrosis factor inhibitors be safely used in pregnancy?
Ali YM & colleagues J Rheumatol. 2010 Jan;37(1):9-17.