The prevalence of #rheumatoidarthritis ๐ ~1%
๐ So ~14 million suffer from RA!
So we ๐ฉโโ๏ธ have to deal with special situations while managing this fairly common disease!
#MedTwitter #MedEd #rheumatology #RheumTwitter
@MedTweetorials @nihardesai7
(1/9)
๐ So ~14 million suffer from RA!
So we ๐ฉโโ๏ธ have to deal with special situations while managing this fairly common disease!
#MedTwitter #MedEd #rheumatology #RheumTwitter
@MedTweetorials @nihardesai7
(1/9)
Let's begin with one of the most beautiful miracles of life โบ๏ธ
#pregnancy in #rheumatoidarthritis
(2/9)
#pregnancy in #rheumatoidarthritis
(2/9)
๐คIs it safe to conceive for a patient with RA? ๐คฐ
๐Overall it is safe โ๏ธโ๏ธโ๏ธ
๐But a mild risk of hypertensive disorders, IUGR and need for caesarian section +!
(3/9)
๐Overall it is safe โ๏ธโ๏ธโ๏ธ
๐But a mild risk of hypertensive disorders, IUGR and need for caesarian section +!
(3/9)
๐ค What happens to arthritis during pregnancy?
๐ฃ 10-15%
๐ 48-60%
๐ 25-40%
#MedTwitter #MedEd
(4/9)
๐ฃ 10-15%
๐ 48-60%
๐ 25-40%
#MedTwitter #MedEd
(4/9)
๐คทWhat to do about the ๐?
๐ซMethotrexate 1-3months prior
๐ซLeflunomide, check levels sos cholestyramine washout
๐ซTNFis, NSAIDs in the 3rd trimester (except certolizumab)
๐ซRituximab,TCZ at conception
โ Sulfasalazine
โ Hydroxychloroquine
โ AZA
๐ฅ Steorids โ if <20mg
(5/9)
๐ซMethotrexate 1-3months prior
๐ซLeflunomide, check levels sos cholestyramine washout
๐ซTNFis, NSAIDs in the 3rd trimester (except certolizumab)
๐ซRituximab,TCZ at conception
โ Sulfasalazine
โ Hydroxychloroquine
โ AZA
๐ฅ Steorids โ if <20mg
(5/9)
What about lactation??? ๐ผ๐จโ๐ผ
All safe except
๐ซ Methotrexate
๐ซ Leflunomide
Amongst NSAIDS, ibuprofen is preferred!
#MedTwitter
(6/9)
All safe except
๐ซ Methotrexate
๐ซ Leflunomide
Amongst NSAIDS, ibuprofen is preferred!
#MedTwitter
(6/9)
โ๏ธHey we forgot about men with RA trying to father a child!
โ Hydroxychloroquine
โ AZA
โ TNFis
โ Rituximab
โ Methotrexate
โ Leflunomide
? JAKibs and Abatacept
rheumatology.org
#MedTwitter
(7/9)
โ Hydroxychloroquine
โ AZA
โ TNFis
โ Rituximab
โ Methotrexate
โ Leflunomide
? JAKibs and Abatacept
rheumatology.org
#MedTwitter
(7/9)
What happens to the disease activity post pregnancy?๐ผ๐จโ๐ผ
๐ฃ๐ฃ๐ฃ 39-50% flare withing 6 months postpartum!
So overall
๐ธPregnancy is safe ๐คฐโบ๏ธ
๐ธ๐ Modifications are needed
๐ธ Regular follow-up is a must โ๏ธ
#MedTwitter #RheumTwitter
(9/9)
๐ฃ๐ฃ๐ฃ 39-50% flare withing 6 months postpartum!
So overall
๐ธPregnancy is safe ๐คฐโบ๏ธ
๐ธ๐ Modifications are needed
๐ธ Regular follow-up is a must โ๏ธ
#MedTwitter #RheumTwitter
(9/9)
Loading suggestions...