What did your rheumatologist tell you about falling pregnant on biologic DMARDs?

By Dr Irwin Lim

Last weekend, I attended a great talk on the effect of rheumatology medications on pregnancy by the dynamic Aussie rheumatology duo, Drs Claire Barrett & Michelle Tellus.

The room was packed. As far as I could tell, noone in the room had (thankfully) experienced a "bad" birth outcome due to one of the DMARDs we use, and luckily, damage to the foetus remains rare with the drugs we use. This topic is so emotive however that talks like this are invariably very well attended.

A couple of weeks ago, I made the following video for our clinic's patients to help spark the conversation:

44 seconds obviously barely scratches the surface of such a complex subject. Usually, it takes me a few consultations over a period of time to negotiate, explain, plan a pregnancy with my patient, the partner, sometimes the wider family, and the other doctors involved.

There's growing evidence that the biologic medications, and in particular, the TNF inhibitors, are relatively safe in pregnancy and can be used if the patient's underlying disease is sufficiently severe to warrant medication use during a pregnancy.

This is obviously a complex decision.

I'm curious what your rheumatologist may have told you about this. Please share.