New pregnancy guidelines launched by The British Society for Rheumatology

The British Society for Rheumatology (BSR) has published two new guidelines for the treatment of rheumatic conditions during conception, pregnancy and breastfeeding. They contain the latest evidence and best practice.

The guidelines have been split into two parts covering:

  1. immunomodulatory anti-rheumatic drugs and corticosteroids
  2. comorbidity medications used in rheumatology practice.

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

They 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 patients with rheumatic disease who are (or are planning to become) pregnant and/or breastfeeding, men with rheumatic disease who are planning to conceive, and patients with rheumatic disease who have unintentionally conceived while taking these medications.

The guidelines feature tables which clearly outline the recommendations of drug compatibility in pregnancy, breastmilk exposure and paternal exposure, as well as generic recommendations for prescribing in rheumatic disease in pregnancy, such as the recommendation that, “The risks and benefits of drug treatment to mother and foetus should be discussed and clearly documented by all healthcare professionals involved in the patient’s care”.

View Table 1: Summary of drug compatibility in pregnancy and breastmilk exposure.

BSR encourages all healthcare professionals involved in managing patients with rheumatic disease to download the updated guidelines and to refer to these in their practice and in discussions with patients, as well as to share the new guidelines with colleagues. An audit tool PDF is also provided to enable practitioners to assess their practice’s compliance with these guidelines.

The guidelines are available now for free at the British Society for Rheumatology and you can also listen to a Buzzsprout podcast (requires login) summarising what’s new in the guidelines and why they matter to patients.

Lindsay Turner

Clinical Guidelines Programme Manager, British Society for Rheumatology