Evidence reviewed for contraception, fertility, pregnancy, HRT, medication use in RMD patients
THURSDAY, Feb. 27, 2020 (HealthDay News) — In an American College of Rheumatology guideline, published online Feb. 23 in Arthritis & Rheumatology, recommendations are presented for the management of reproductive health in women and men with rheumatic and musculoskeletal diseases (RMD).
Lisa R. Sammaritano, M.D., from Weill Cornell Medicine in New York City, and colleagues conducted a systematic review of the evidence relating to contraception, assisted reproductive technologies, fertility preservation, hormone replacement therapy, pregnancy and lactation, and medication use in patients with RMD. Recommendations were developed and their strength was graded; when indirect evidence was sufficiently compelling, good practice statements were agreed upon.
The authors developed 12 ungraded good practice statements and 131 graded recommendations for reproductive health care. The recommendations are relevant to all patients with RMD, unless otherwise indicated. The recommendations support the principles of use of safe and effective contraception to prevent unplanned pregnancy, prepregnancy counseling to encourage conception during disease quiescence and while receiving medications that are compatible with pregnancy, and ongoing physician-patient discussion of all reproductive health issues.
“This guideline should open avenues of communication between the rheumatologist and the patient, as well as between the rheumatologist and the ob-gyn,” Sammaritano said in a statement. “A better understanding of the risks and benefits of reproductive health options will enhance patient care by providing safe and effective contraception, improving pregnancy outcomes by conceiving during inactive disease periods, and allowing for continued control of rheumatic diseases during and after pregnancy with the use of well-suited medications.”
Several authors disclosed financial ties to the pharmaceutical industry.
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