The positive effect of pregnancy in rheumatoid arthritis and the use of medications for the management of rheumatoid arthritis during pregnancy

被引:0
作者
Uday Raj Sharma
Akhila Nediyedath Rathnakaran
B. P. Prudhvi Raj
Gayathry Padinjakkara
Akanksh Das
Surendra Vada
Manjunatha P. Mudagal
机构
[1] Acharya and BM Reddy College of Pharmacy,
来源
Inflammopharmacology | 2021年 / 29卷
关键词
Rheumatoid arthritis; Pregnancy; DMARDs; Biologics; NSAIDs; Corticosteroids;
D O I
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学科分类号
摘要
Rheumatoid arthritis (RA) is an autoimmune systemic inflammatory disorder that is mostly characterised by progressive symmetrical joint destruction, particularly in the wrist and fingers, while it may also affect additional joints and several organs, such as the skin, heart, blood vessels, and lungs. It is identified by raised anti-rheumatoid factor and anti-cyclic citrullinated peptide antibodies. The chemical mediators involved in the activity of RA are IL-1β, TNF-α, and IL-6. Pregnancy exerts a positive effect on RA that helps to modulate the disease condition. Different hypotheses are recommended to explain the ameliorating effect of pregnancy in RA. RA cannot be completely cured. The treatment goal is the attrition of pain and inflammation and the further progression of the disease. Long-term management of RA is carried out using disease-modifying antirheumatic drugs (DMARDs). Therapy of acute flares can be done with Non-steroidal anti-inflammatory drugs (NSAIDs) accompanied by ad interim usage of glucocorticoids. Biologic response modifiers are also available; they act by abolishing the activity of T- cells. However, it is necessary to select the correct treatment regimen when it comes to the management of RA in pregnancy.
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页码:987 / 1000
页数:13
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共 497 条
[1]  
Baecher-Allan C(2005)CD4+ CD25high regulatory cells in human peripheral blood J Immunol 167 1245-1253
[2]  
Brown JA(1896)Rheumatoid arthritis:its clinical history, etiology, and pathology The Lancet 147 1120-1125
[3]  
Freeman GJ(1999)Does rheumatoid arthritis remit during pregnancy and relapse postpartum? Results from a nationwide study in the United Kingdom performed prospectively from late pregnancy Arthritis Rheum 57 51-55
[4]  
Hafler DA(1998)Adult and two children with fetal methotrexate syndrome Teratology 81 936-945
[5]  
Bannatyne G(1972)The transplacental passage of prednisone and prednisolone in pregnancy near term J Paediatrics 8 475-476
[6]  
Wohlmann A(2010)Adalimumab level in breast milk of a nursing mother Clin Gastroenterol Hepatol 68 1794-1795
[7]  
Barrett JH(2009)A patient’s wish: anakinra in pregnancy Ann Rheum Dis 1 31-39
[8]  
Brennan P(1980)Disposition of ssalicylazosulfapyridine (Azulfidine) and metabolites in human breast milk Dev Pharmacol Ther 26 334-340
[9]  
Fiddler M(2014)Non-steroidal anti-inflammatory drugs, glucocorticoids and disease-modifying anti-rheumatic drugs for the management of rheumatoid arthritis before and during pregnancy Curr Opin Rheumatol 21 73-80
[10]  
Silman AJ(2014)Use of corticosteroids in early pregnancy is not associated with risk of oral clefts and other congenital malformations in offspring Am J Ther 127 264-267