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Antirheumatic drugs and reproduction in women and men with chronic arthritis

The impact of rheumatic disease on fertility and reproduction can be remarkable. Many disease-related factors can influence patients’ sexual functioning, perturb fertility and limit family planning. Antirheumatic pharmacological treatment can also have a crucial role in this field. Proper counsellin...

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Autores principales: Bazzani, Chiara, Andreoli, Laura, Agosti, Michele, Nalli, Cecilia, Tincani, Angela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4632146/
https://www.ncbi.nlm.nih.gov/pubmed/26557371
http://dx.doi.org/10.1136/rmdopen-2015-000048
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author Bazzani, Chiara
Andreoli, Laura
Agosti, Michele
Nalli, Cecilia
Tincani, Angela
author_facet Bazzani, Chiara
Andreoli, Laura
Agosti, Michele
Nalli, Cecilia
Tincani, Angela
author_sort Bazzani, Chiara
collection PubMed
description The impact of rheumatic disease on fertility and reproduction can be remarkable. Many disease-related factors can influence patients’ sexual functioning, perturb fertility and limit family planning. Antirheumatic pharmacological treatment can also have a crucial role in this field. Proper counselling, preferably provided by a multidisciplinary team of rheumatologists, obstetricians, gynaecologists and neonatologists, is recommended for patients taking antirheumatic drugs, not only at the beginning, but also during the course of treatment. Paternal exposure to antirheumatic drugs was not found to be specifically associated with congenital malformation and adverse pregnancy outcome, therefore discontinuation of these drugs while planning for conception should be weighed against the risk of disease flare. Drugs in Food and Drug Administration (FDA) category ‘X’ should be withdrawn in a timely manner in women who desire a pregnancy. Meanwhile, disease control can be achieved with anti-tumour necrosis factor (TNF)-α agents, which are not teratogenic drugs. If maternal disease control is permissive, they can be stopped as soon as the pregnancy test turns positive and be resumed during pregnancy in case of a flare.
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spelling pubmed-46321462015-11-09 Antirheumatic drugs and reproduction in women and men with chronic arthritis Bazzani, Chiara Andreoli, Laura Agosti, Michele Nalli, Cecilia Tincani, Angela RMD Open Proceedings from OsteoRheumatology 2014 The impact of rheumatic disease on fertility and reproduction can be remarkable. Many disease-related factors can influence patients’ sexual functioning, perturb fertility and limit family planning. Antirheumatic pharmacological treatment can also have a crucial role in this field. Proper counselling, preferably provided by a multidisciplinary team of rheumatologists, obstetricians, gynaecologists and neonatologists, is recommended for patients taking antirheumatic drugs, not only at the beginning, but also during the course of treatment. Paternal exposure to antirheumatic drugs was not found to be specifically associated with congenital malformation and adverse pregnancy outcome, therefore discontinuation of these drugs while planning for conception should be weighed against the risk of disease flare. Drugs in Food and Drug Administration (FDA) category ‘X’ should be withdrawn in a timely manner in women who desire a pregnancy. Meanwhile, disease control can be achieved with anti-tumour necrosis factor (TNF)-α agents, which are not teratogenic drugs. If maternal disease control is permissive, they can be stopped as soon as the pregnancy test turns positive and be resumed during pregnancy in case of a flare. BMJ Publishing Group 2015-08-15 /pmc/articles/PMC4632146/ /pubmed/26557371 http://dx.doi.org/10.1136/rmdopen-2015-000048 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Proceedings from OsteoRheumatology 2014
Bazzani, Chiara
Andreoli, Laura
Agosti, Michele
Nalli, Cecilia
Tincani, Angela
Antirheumatic drugs and reproduction in women and men with chronic arthritis
title Antirheumatic drugs and reproduction in women and men with chronic arthritis
title_full Antirheumatic drugs and reproduction in women and men with chronic arthritis
title_fullStr Antirheumatic drugs and reproduction in women and men with chronic arthritis
title_full_unstemmed Antirheumatic drugs and reproduction in women and men with chronic arthritis
title_short Antirheumatic drugs and reproduction in women and men with chronic arthritis
title_sort antirheumatic drugs and reproduction in women and men with chronic arthritis
topic Proceedings from OsteoRheumatology 2014
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4632146/
https://www.ncbi.nlm.nih.gov/pubmed/26557371
http://dx.doi.org/10.1136/rmdopen-2015-000048
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