Continuation of biologics therapy improves flare during pregnancy
Continued use of biologics therapy among women with psoriatic arthritis (PsA) appears to reduce the level of disease activity and probability of flare during pregnancy, while stopping treatment prior to conception correlates with flare during pregnancy and the postpartum period, a study has shown.
A total of 25 women with PsA and 35 pregnancies were included. Of the pregnancies, 33 resulted in live healthy babies. No significant change was observed in disease activity throughout pregnancy in the whole group, while patients in 16 pregnancies (48 percent) worsened during the first postpartum year.
Of the 21 pregnancies in which women had been treated with biologics prior to conception, 15 discontinued treatment close to pregnancy or during the first trimester. Five of those 15 patients had been classified as having mild to severe PsA activity before pregnancy. This number rose to eight, nine and 14 during the first and second trimesters and postpartum period, respectively.
The degree of disease activity did not significantly change in six patients who continued using the biologics therapy beyond the first trimester. Nonbiologics-treated patients also showed improvement in disease activity during pregnancy.
Corticosteroids were administered or the dosage was increased during six pregnancies in patients whose biologics were ceased prior to conception.
This retrospective case series sought to assess the effect of pregnancy on disease activity in PsA. The authors reviewed the medical files of all female patients followed at the PsA clinic of two medical centres and identified those with at least one pregnancy during follow-up and one visit during or soon after pregnancy.