Highly Accessed Review

Anti-inflammatory and immunosuppressive drugs and reproduction

Monika Østensen1*, Munther Khamashta2, Michael Lockshin3, Ann Parke4, Antonio Brucato5, Howard Carp6, Andrea Doria7, Raj Rai8, Pierluigi Meroni9, Irene Cetin10, Ronald Derksen11, Ware Branch12, Mario Motta13, Caroline Gordon14, Guillermo Ruiz-Irastorza15, Arsenio Spinillo16, Deborah Friedman17, Rolando Cimaz18, Andrew Czeizel19, Jean Charles Piette20, Ricard Cervera21, Roger A Levy22, Maurizio Clementi23, Sara De Carolis23, Michelle Petri24, Yehuda Shoenfeld25, David Faden2629, Guido Valesini27 and Angela Tincani28

Author Affiliations

1 Department of Rheumatology and Clinical Immunology/Allergology, University Hospital of Bern, Switzerland

2 Lupus Research Unit, The Rayne Institute, St Thomas' Hospital, London, UK

3 Joan and Sanford Weill College of Medicine of Cornell University, Barbara Volcker Center for Women and Rheumatic Disease, Hospital for Special Surgery, New York, USA

4 Division of Rheumatic Diseases, Department of Medicine, University of Connecticut Health Center, Farmington, USA

5 Department of Internal Medicine and Rheumatology, Niguarda Hospital, Milano, Italy

6 Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel, and Tel Aviv University, Israel

7 Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Padova, Italy

8 Department of Obstetrics and Gynaecology, Imperial College School of Medicine, London, UK

9 Cattedra di Medicina Interna, University of Milano, Italy

10 Institute of Obstetrics and Gynecology, L Mangiagalli, University of Milano, Italy

11 Department of Rheumatology and Clinical Immunology, University Medical Centre Utrecht, The Netherlands

12 Department of Obstetrics and Gynecology, The University of Utah Health Sciences Center, Salt Lake City, Utah, USA

13 Neonatology and Neonatal Intensive Care Unit, Spedali Civili, Brescia, Italy

14 Centre for Immune Regulation, Division of Immunity and Infection, The University of Birmingham, Birmingham, UK

15 Department of Internal Medicine, Hospital de Cruces, University of The Basque Country, Bizkaia, Spain

16 Department of Obstetrics and Gynecology, University of Pavia, Italy

17 University of Texas, Health Science Center, Houston, USA

18 Pediatrics, Fondazione Policlinico Mangiagalli, Milano, Italy

19 Foundation for the Community Control of Hereditary Diseases, Budapest, Hungary

20 Service de Médecine Interne, Groupe Hospitalier Pitié-Salpêtrière, Paris, France

21 Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Catalonia, Spain

22 Discipline of Rheumatology, Faculdades de Ciencias Medicas, Universidade do Estado do Rio de Janeiro, Brazil

23 Department of Obstetrics and Gynecology, Catholic University of Sacred Heart, Rome, Italy

24 Lupus Center, Johns Hopkins University School of Medicine, Division of Rheumatology, Baltimore, USA

25 Department of Medicine and Center for Autoimmune Diseases, Sheba Medical Center, Tel-Aviv University, Tel-Hashomer, Israel

26 Obstetric and Gynecology Department, University and Hospital of Brescia, Italy

27 Cattedra di Reumatologia, Università 'La Sapienza', Roma, Italy

28 Rheumatology and Clinical Immunology, University and Hospital of Brescia, Italy

29 Deceased in 2005

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Arthritis Research & Therapy 2006, 8:209  doi:10.1186/ar1957

Published: 11 May 2006

Abstract

Rheumatic diseases in women of childbearing years may necessitate drug treatment during a pregnancy, to control maternal disease activity and to ensure a successful pregnancy outcome. This survey is based on a consensus workshop of international experts discussing effects of anti-inflammatory, immunosuppressive and biological drugs during pregnancy and lactation. In addition, effects of these drugs on male and female fertility and possible long-term effects on infants exposed to drugs antenatally are discussed where data were available. Recommendations for drug treatment during pregnancy and lactation are given.