The treatment of rheumatoid arthritis during pregnancy

There are a wide variety of medications available to treat patients with rheumatoid arthritis, many of which are considered unsafe during pregnancy. It is important to tailor a treatment regimen that stabilises the woman’s disease prior to conception, using medications that are safe to continue throughout pregnancy and the post-partum period. Drugs that may be safely used during pregnancy include NSAIDs, corticosteroids, plus several DMARDs, including sulfasalazine and hydroxychloroquine. Drugs recommended to be stopped before pregnancy include methotrexate and leflunomide, plus the biologics: anti-TNF agents, rituximab and abatacept.