Prescribing of sulfasalazine, azathioprine and methotrexate round pregnancy—a descriptive study

Authors

  • Fokaline Vroom Msc,

    1. University of Groningen, Department of Social Pharmacy, Pharmacoepidemiology and Pharmacotherapy, GUIDE Graduate school for Drug Exploration, Groningen, The Netherlands
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  • Eric N. van Roon PhD,

    1. University of Groningen, Department of Social Pharmacy, Pharmacoepidemiology and Pharmacotherapy, GUIDE Graduate school for Drug Exploration, Groningen, The Netherlands
    2. Department of Clinical Pharmacy & Clinical Pharmacology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
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  • Paul B. van den Berg Pharm D,

    1. University of Groningen, Department of Social Pharmacy, Pharmacoepidemiology and Pharmacotherapy, GUIDE Graduate school for Drug Exploration, Groningen, The Netherlands
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  • Jacobus R.B.J. Brouwers PhD,

    1. University of Groningen, Department of Social Pharmacy, Pharmacoepidemiology and Pharmacotherapy, GUIDE Graduate school for Drug Exploration, Groningen, The Netherlands
    2. Department of Clinical Pharmacy & Clinical Pharmacology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
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  • Lolkje T.W. de Jong-van den Berg PhD

    Corresponding author
    1. University of Groningen, Department of Social Pharmacy, Pharmacoepidemiology and Pharmacotherapy, GUIDE Graduate school for Drug Exploration, Groningen, The Netherlands
    • Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.
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  • The authors have no potential conflict of interest.

Abstract

Purpose

Continuation or discontinuation of drugs during pregnancy in chronic diseases is an issue of concern. Information on prescribing of disease modifying anti-rheumatic drugs (DMARDs) during pregnancy is scarce. In this study, we report prescribing patterns round pregnancy of sulfasalazine (SSZ), azathioprine (AZA), methotrexate (MTX) and co-medications among women to whom one of these DMARDs were prescribed before pregnancy.

Methods

The pregnancy-interaction database (IADB.nl, 1994–2004), containing pharmacy dispensing data from Northern- Netherlands, was used. Women to whom SSZ (N = 13), AZA (N = 10) or MTX (N = 6) was prescribed before their first pregnancy were identified and described in detail.

Results

AZA and SSZ are continued during pregnancy by 60% and 38% of the women, respectively, MTX was stopped before pregnancy. Among women receiving SSZ (N = 13) as their initial DMARD, anti-inflammatory and anti-rheumatic drugs (69%) and analgesics (45%) were the most commonly prescribed co-medications. Among women receiving AZA (N = 8) as their initial DMARD, corticosteroids for systemic use (100%) and intestinal anti-inflammatory agents (88%) were the most commonly prescribed co-medications. All women receiving intestinal anti-inflammatory drugs before pregnancy continued this during pregnancy, in contrast to other co-medications which were mainly discontinued.

Conclusions

Our study showed that DMARDs and co-medication are received before, during and after pregnancy, although no specific prescription patterns were found. Administrative databases, such as the pregnancy-IADB.nl, are useful in describing drug-prescribing patterns for better understanding of drug prescribing around pregnancy in daily practice. Based on these data, we conclude that prescribing of DMARDs and related co-medication is based on the individual patient. Copyright © 2007 John Wiley & Sons, Ltd.

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