A healthy pregnancy despite illness



Rheumatoid arthritis (RA) affects approximately 1% of the population, and women are three times more likely to suffer from the disease than men. Is it safe for a woman who has been diagnosed with rheumatoid arthritis to take RA medication while pregnant?

New types of medications may be taken without placing the foetus at undue risk.

The research led by Dr. Évelyne Vinet and her team at the Research Institute of the McGill University Health Centre (RI-MUHC) has shown that new types of medications may be taken by pregnant patients without placing the foetus at undue risk. Unlike osteoarthritis, which causes premature aging of the joints, rheumatoid arthritis can destroy the joints and even attack a person's organs if left untreated.

In the past 20 years, highly effective biologic drugs known as TNF (tumor necrosis factor) inhibitors have been developed to treat rheumatoid arthritis but most are monoclonal antibodies that can cross the placenta and end up at concentrations that are too high for the foetus. Dr. Vinet and her collaborators therefore reviewed the data from an American database that includes information on approximately 3 000 children born of mothers who suffer from RA, including 380 who took TNF inhibitors while pregnant. As it turns out, the drugs, which can impact the immune system, do not seem to present a higher risk of infection for the foetus.

Still, further studies are required to confirm the safety of the treatment. Évelyne Vinet, who is also a researcher in the Department of Medicine at McGill University, has set her sights on studying all cases in which a foetus is exposed to TNF inhibitors, including pregnant women suffering from other autoimmune diseases such as Crohn's disease, ulcerative colitis and psoriasis.