Treatment of pregnant and non-pregnant rheumatic patients: a survey among Dutch rheumatologists

Authors

  • F. Vroom MSc,

    1. Department of Social Pharmacy, Pharmacoepidemiology and Pharmacotherapy, GUIDE Graduate School for Drug Exploration, University of Groningen, Groningen, The Netherlands
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  • M.A.J.F. Van De Laar MD PhD,

    1. Department of Rheumatology, Medisch Spectrum Twente, Enschede, The Netherlands
    2. Institute for Behavioral Research, University Twente, Enschede, The Netherlands
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  • E.N. Van Roon PharmD PhD,

    1. Department of Social Pharmacy, Pharmacoepidemiology and Pharmacotherapy, GUIDE Graduate School for Drug Exploration, University of Groningen, Groningen, The Netherlands
    2. Department of Clinical Pharmacy & Clinical Pharmacology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
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  • J.R.B.J. Brouwers PharmD PhD,

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

    1. Department of Social Pharmacy, Pharmacoepidemiology and Pharmacotherapy, GUIDE Graduate School for Drug Exploration, University of Groningen, Groningen, The Netherlands
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L.T.W. de Jong-van den Berg, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands. Tel.: +3150 363 3330; fax: +3150 363 2772; e-mail: l.t.w.de.jong-van.den.berg@rug.nl

Summary

Background:  The aim of this study was to explore, among Dutch rheumatologists, aspects such as attitude towards guidelines, pharmacotherapy and information needs in the treatment of pregnant as well as non-pregnant rheumatoid arthritis (RA) patients.

Methods:  Fifteen rheumatologists from nine different hospitals were interviewed by means of a semi-structured interview. Questions addressing attitude towards guidelines, pharmacotherapy preferences and information needs with respect to the pregnant and non-pregnant patient were asked. The analysis will be based on descriptive statistics.

Results:  Guidelines are used by almost half of the hospitals with respect to pregnant RA patients and by all hospitals for RA patients in general. With respect to pregnant women, nine respondents preferred stopping the medication as soon pregnancy is known. When treating RA patients, in general sulfasalazine and methotrexate would be drugs of first choice. Information is found in international and national books and guidelines.

Conclusion:  Dutch rheumatologists are of the view that there is sufficient information on the treatment of RA in pregnant women or women wishing to become pregnant, except for safe use of medication during pregnancy. In the future, pregnancy risk categorization should be updated and discussed regularly. This should be based on more recent literature and experience. A good monitoring system for following all young patients with a rheumatic disease should be set up as a first step to collect more information on the safe use of medication during pregnancy.

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