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Title: Management of chronic rheumatic diseases in women 18-45 years of age in Asia Pacific: insights from patient and clinician surveys.
Austin Authors: Tanaka, Yoshiya;Barrett, Claire;Hirano, Yuji;Ikeda, Kei;Paizis, Kathy ;Sameshima, Azusa;Mountian, Irina;Wong, Priscilla C
Affiliation: Western Health, St Albans, Australia
Redcliffe Hospital, Redcliffe and University of Queensland, St Lucia, Australia
University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
Toyohashi Municipal Hospital, Toyohashi, Japan..
Chiba University Hospital, Chiba, Japan..
University of Toyama, Toyama, Japan..
UCB Pharma, Brussels, Belgium..
The Chinese University of Hong Kong, Hong Kong, HK, Hong Kong..
Issue Date: Apr-2023
Date: 2022
Publication information: Rheumatology International 2023; 43(4)
Abstract: Perspectives of women aged 18-45 years with chronic rheumatic diseases (CRD), and clinicians, in the Asia-Pacific (APAC) region are reported. Online surveys were completed by women, pregnant in the past 2-5 years, with moderate to severe rheumatoid arthritis (RA), psoriatic arthritis (PsA), axial spondyloarthritis (axSpA), and rheumatologists, obstetricians, orthopaedic surgeons who medically manage CRDs. Among 210 (RA 122, PsA 48, axSpA 40) patients, 52% (n = 109/210) delayed their decision to have children, most commonly due to concerns of passing on disease to offspring. 33% (n = 70/210) discussed family planning with a healthcare professional at diagnosis. Patients most often initiated discussions. 94% (n = 193/205) stopped treatment around pregnancy due to fear of fetal harm. 66% (n = 139/210) of patients felt they did not receive all relevant information on the impact of CRDs and treatment on pregnancy. Among 335 clinicians who participated, 82% (n = 143/174) of rheumatologists, 86% (n = 72/84) of obstetricians and 43% (n = 33/77) of orthopaedic surgeons agreed good disease control during pregnancy was their primary goal. 69% (n = 120/174) of rheumatologists were 'very comfortable' with prescribing tumour necrosis factor inhibitors (TNFi) for women aged 18-45 years. Comfort levels generally decreased with the onset of family planning. More obstetricians and orthopaedic surgeons supported avoiding TNFi during pregnancy than rheumatologists (40% [n = 34/84]/38% [n = 29/77] versus 16% [n = 28/174]). Access to more TNFi safety data during pregnancy was considered paramount for increasing clinician comfort. Patients and physicians need current information and multidisciplinary discussions for improved management of CRD in women in APAC.
DOI: 10.1007/s00296-022-05206-0
Journal: Rheumatology international
PubMed URL: 36163594
Type: Journal Article
Subjects: Chronic rheumatic diseases
Family planning
Tumour necrosis factor inhibitors
Appears in Collections:Journal articles

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