01 November 2022

We’ve launched two updated guidelines containing evidence and best practice for prescribing rheumatology medications during pregnancy and breastfeeding.

Professor Ian Giles, who led the guidelines, said: “The use of medications in pregnancy often causes concern. We’ve reviewed all the latest evidence in the development of these guidelines to make recommendations on using rheumatological drugs during conception, all stages of pregnancy, breastfeeding and in men who wish to conceive.”

The guidelines have been split into two parts covering:

  1.  prescribing medications to treat co-morbidities in rheumatic diseases during pregnancy and breastfeeding
  2.  prescribing immunomodulatory drugs during pregnancy and breastfeeding, including biologics and small molecule drugs

These guidelines update the ones published in 2016 and cover newer treatments, such as more recent biologics and small molecule drugs. Using the latest information and evidence, they advise on the timing of using medicines and give clinicians an important resource when treating pregnant patients.

They were developed by members from rheumatology as well as a wider working group made up of obstetricians, obstetric physicians, pharmacists, GPs and patients.

Clare Reid, lay member of the working group said: “Information is power and these guidelines are a way to really empower the patient and involve us in decision making so we understand the pros and cons of each medication we may be on. It means that we can forward plan so we can have as normal an experience of pregnancy and breastfeeding as possible.”

Professor Giles said: “Pregnancy is one of the most important times in a person’s life, and those with rheumatic conditions have so much more to think about. Controlling disease during pregnancy is vital and most medications are safe to use. We hope these guidelines will support clinicians and give them the confidence to use medicines in pregnant patients.”

The guidelines are available now for free on our website.

Join Professor Ian Giles, lead authors Dr Mark Russell and Dr Karen Schreiber, and lay member Clare Reid in a roundtable discussion about what’s new with the guidelines and what difference they will make to patients, hosted by Dr Marwan Bukhari for the latest episode of the Talking Rheumatology podcast.