Валеология: Здоровье, Болезнь, Выздоровление. 2019; : 9-13
ЛЕЧЕНИЕ РЕВМАТОИДНОГО АРТРИТА У БЕРЕМЕННЫХ
Аннотация
В данной статье описывается проблема применения различных препаратов для лечения ревматоидного артрита у беременных, а также частота возникновения возможных побочных эффектов и степень тератогенности для плода. В связи с увеличением частоты встречаемости заболевших ревматоидным артритом женщин, желающих иметь детей в будущем, рассматриваются альтернативные эффективные варианты лечения препаратов и представлены результаты исследований частоты развития возможных побочных эффектов. В Казахстанском Национальном формуляре для препаратов группы фторхинолонов указано противопоказание для применения - возраст детей до 18 лет, в сравнении с Британским, в котором препараты данной группы показаны для применения с периода новорожденности для лечения тяжелых инфекций. В данном литературном обзоре представлены примеры применения данных препаратов в мировой педиатрической практике.
Список литературы
1. Wallenius M., Skomsvoll J. F., Irgens L. M., et al. Fertility in women with chronic inflammatory arthritides. Rheumatology (Oxford) 2011; 50 (6) : 1162–7.
2. Berthelot, J. M. et al. exposition to anti‐TNF drugs during pregnancy: outcome of 15 cases and review of the literature. Joint Bone Spine 76, 28–34 (2009).
3. Mahadevan, U. et al. infliximab levels in infants born to women with inflammatory bowel disease. Gastroenterology 132 (Suppl. 1), A‐144.
4. Carter, J. D., Ladhani, A., Ricca, L. R., Valeriano, J. & Vasey, F. B. A safety assessment of TNF Antagonists during pregnancy: a review of the Food and Drug Administration database.J. Rheumatol. 36, 635–641 (2009).
5. Østensen, M. Are TNF inhibitors safe in pregnancy? Nat. Rev. Rheumatol. 5, 184–185 (2009).
6. Patlas, N. et al. Transplacental effects of bisphosphonates on fetal skeletal ossification and mineralization in rats. Teratology 60, 68–73 (1999).
7. Rutgers‐Verhage, A. R., Devries, T. W. & Torringa, M. J. No effects of bisphosphonates on the human fetus. Birth Defects Res. A Clin. Mol. Teratol. 67, 203–204 (2003).
8. Ornoy, A., Wajnberg, R. & Diav‐Citrin, O. The outcome of pregnancy following pre‐pregnancy or early pregnancy alendronate treatment. Reprod. Toxicol. 22, 578–579 (2006).
9. Hyrich, K., Symmons, D., Watson, K. & Silman, A. Pregnancy outcome in women who were exposed to anti‐TNF agents: results from a national population register. Arthritis Rheum. 54, 2701–2702 (2006).
10. Vasiliauskas, E. A. et al. evidence for transplacental transfer of maternally administered infliximab to the newborn. Clin. Gastroenterol. Hepatol. 4, 1255–1258 (2006).
11. Mahadevan, U. et al. infliximab levels in infants born to women with inflammatory bowel disease. Gastroenterology 132 (Suppl. 1), A‐144.
12. Mahadevan, U. et al. intentional infliximab use during pregnancy for induction or maintenance of remission in Crohn’s disease. Aliment. Pharmacol. Ther. 21, 733–738 (2005).
13. Carter, J. D., Valeriano, J. & vasey, F. B. Tumor necrosis factor alpha inhibition and vATer association: a causal relationship? J. Rheumatol. 33, 1014–1017 (2006).
14. Patlas, N. et al. Transplacental effects of bisphosphonates on fetal skeletal ossification and mineralization in rats. Teratology 60, 68–73 (1999).
15. Orencia®(abatacept; lyophilized powder for intravenous infusion) package insert (Bristol– Myers squibb, 2008).
16. Moskovitz, D. N. et al. The effect on the fetus of medications used to treat pregnant inflammatory bowel‐disease patients. Am. J. Gastroenterol. 99, 656–661 (2004).
17. Rahimi, R., Nikfar, S., Rezaie, A. & Abdollahi, M. Pregnancy outcome in women with inflammatory bowel disease following exposure to 5‐aminosalicylic acid drugs: a meta‐analysis. Reprod. Toxicol. 25, 271–275 (2008).
18. Hernandez‐Diaz, S., Werler, M. M., Walker, A. M. & Mitchell, A. A. Folic acid antagonists during pregnancy and the risk of birth defects. N. Engl. J. Med. 343, 1608–1614 (2000).
19. Katchamart, W., Trudeau, J., Phumethum, V. & Bombardier, C. The efficacy and toxicity of Methotrexate (MTX) monotherapy vs. MTX.
20. Combination therapy with non‐biologic disease‐ modifying anti rheumatic drugs in rheumatoid arthritis: a systematic review and metaanalysis. Ann. Rheum. Dis. doi:10.1136/ard.2008.099861
21. Friedman, J. M. Teratogen update: azathioprine and 6‐mercaptopurine. Teratology 65, 240–261 (2002).
22. Goldstein, L. H. et al. Pregnancy outcome of women exposed to azathioprine during pregnancy. Birth Defects Res. A Clin. Mol. Teratol. 79, 696–701 (2007).
23. Lamarque, V., Leleu, M. F., Monka, C. & Krupp, P. Analysis of 629 pregnancy outcomes in transplant recipients treated with sandimmun. Transplant. Proc. 29, 2480 (1997).
24. Skomsvoll J. F., Ostensen M., Irgens L. M., et al. Perinatal outcome in pregnancies of women with connective tissue disease and inflammatory rheumatic disease in Norway. Scand J Rheumatol 1999; 28 (6) : 352–6.
25. Bharti B., Lee S. J., Lindsay S. P., et al. Disease severity and pregnancy outcomes in women with rheumatoid arthritis: results from the organization of teratology infor- mation specialists autoimmune diseases in pregnancy project. J Rheumatol 2015; 42(8) : 1376–82.
26. Brouwer J., Laven J. S., Hazes J. M., et al. Brief report: miscarriages in female rheu- matoid arthritis patients: associations with serologic findings, disease activity, and antirheumatic drug treatment. Arthritis Rheumatol 2015; 67 (7) : 1738–43.
Valeology: Health - Illnes - recovery. 2019; : 9-13
TREATMENT OF RHEUMATOID ARTHRITIS DURING PREGNANCY
Abstract
This article describes the problem of using various drugs for the treatment of rheumatoid arthritis in pregnant women, the frequency of occurrence of possible side effects and the degree of teratogenicity for the fetus. In connection with the increase in the incidence of women with rheumatoid arthritis who wish to have children in the future, alternative effective treatment options are being considered and the results of studies on the incidence of possible side effects are provided. The Kazakhstan National Formulary for fluoroquinolone drugs indicated a contraindication for use - the age of children under 18 years old, compared with the British one, in which the drugs of this group are indicated for use from the neonatal period for the treatment of severe infections. This literature review presents examples of the use of these drugs in the world of pediatric practice.
References
1. Wallenius M., Skomsvoll J. F., Irgens L. M., et al. Fertility in women with chronic inflammatory arthritides. Rheumatology (Oxford) 2011; 50 (6) : 1162–7.
2. Berthelot, J. M. et al. exposition to anti‐TNF drugs during pregnancy: outcome of 15 cases and review of the literature. Joint Bone Spine 76, 28–34 (2009).
3. Mahadevan, U. et al. infliximab levels in infants born to women with inflammatory bowel disease. Gastroenterology 132 (Suppl. 1), A‐144.
4. Carter, J. D., Ladhani, A., Ricca, L. R., Valeriano, J. & Vasey, F. B. A safety assessment of TNF Antagonists during pregnancy: a review of the Food and Drug Administration database.J. Rheumatol. 36, 635–641 (2009).
5. Østensen, M. Are TNF inhibitors safe in pregnancy? Nat. Rev. Rheumatol. 5, 184–185 (2009).
6. Patlas, N. et al. Transplacental effects of bisphosphonates on fetal skeletal ossification and mineralization in rats. Teratology 60, 68–73 (1999).
7. Rutgers‐Verhage, A. R., Devries, T. W. & Torringa, M. J. No effects of bisphosphonates on the human fetus. Birth Defects Res. A Clin. Mol. Teratol. 67, 203–204 (2003).
8. Ornoy, A., Wajnberg, R. & Diav‐Citrin, O. The outcome of pregnancy following pre‐pregnancy or early pregnancy alendronate treatment. Reprod. Toxicol. 22, 578–579 (2006).
9. Hyrich, K., Symmons, D., Watson, K. & Silman, A. Pregnancy outcome in women who were exposed to anti‐TNF agents: results from a national population register. Arthritis Rheum. 54, 2701–2702 (2006).
10. Vasiliauskas, E. A. et al. evidence for transplacental transfer of maternally administered infliximab to the newborn. Clin. Gastroenterol. Hepatol. 4, 1255–1258 (2006).
11. Mahadevan, U. et al. infliximab levels in infants born to women with inflammatory bowel disease. Gastroenterology 132 (Suppl. 1), A‐144.
12. Mahadevan, U. et al. intentional infliximab use during pregnancy for induction or maintenance of remission in Crohn’s disease. Aliment. Pharmacol. Ther. 21, 733–738 (2005).
13. Carter, J. D., Valeriano, J. & vasey, F. B. Tumor necrosis factor alpha inhibition and vATer association: a causal relationship? J. Rheumatol. 33, 1014–1017 (2006).
14. Patlas, N. et al. Transplacental effects of bisphosphonates on fetal skeletal ossification and mineralization in rats. Teratology 60, 68–73 (1999).
15. Orencia®(abatacept; lyophilized powder for intravenous infusion) package insert (Bristol– Myers squibb, 2008).
16. Moskovitz, D. N. et al. The effect on the fetus of medications used to treat pregnant inflammatory bowel‐disease patients. Am. J. Gastroenterol. 99, 656–661 (2004).
17. Rahimi, R., Nikfar, S., Rezaie, A. & Abdollahi, M. Pregnancy outcome in women with inflammatory bowel disease following exposure to 5‐aminosalicylic acid drugs: a meta‐analysis. Reprod. Toxicol. 25, 271–275 (2008).
18. Hernandez‐Diaz, S., Werler, M. M., Walker, A. M. & Mitchell, A. A. Folic acid antagonists during pregnancy and the risk of birth defects. N. Engl. J. Med. 343, 1608–1614 (2000).
19. Katchamart, W., Trudeau, J., Phumethum, V. & Bombardier, C. The efficacy and toxicity of Methotrexate (MTX) monotherapy vs. MTX.
20. Combination therapy with non‐biologic disease‐ modifying anti rheumatic drugs in rheumatoid arthritis: a systematic review and metaanalysis. Ann. Rheum. Dis. doi:10.1136/ard.2008.099861
21. Friedman, J. M. Teratogen update: azathioprine and 6‐mercaptopurine. Teratology 65, 240–261 (2002).
22. Goldstein, L. H. et al. Pregnancy outcome of women exposed to azathioprine during pregnancy. Birth Defects Res. A Clin. Mol. Teratol. 79, 696–701 (2007).
23. Lamarque, V., Leleu, M. F., Monka, C. & Krupp, P. Analysis of 629 pregnancy outcomes in transplant recipients treated with sandimmun. Transplant. Proc. 29, 2480 (1997).
24. Skomsvoll J. F., Ostensen M., Irgens L. M., et al. Perinatal outcome in pregnancies of women with connective tissue disease and inflammatory rheumatic disease in Norway. Scand J Rheumatol 1999; 28 (6) : 352–6.
25. Bharti B., Lee S. J., Lindsay S. P., et al. Disease severity and pregnancy outcomes in women with rheumatoid arthritis: results from the organization of teratology infor- mation specialists autoimmune diseases in pregnancy project. J Rheumatol 2015; 42(8) : 1376–82.
26. Brouwer J., Laven J. S., Hazes J. M., et al. Brief report: miscarriages in female rheu- matoid arthritis patients: associations with serologic findings, disease activity, and antirheumatic drug treatment. Arthritis Rheumatol 2015; 67 (7) : 1738–43.
