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Family planning for women with immunological conditions

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    For women living with immunological conditions, like rheumatoid arthritis, ankylosing spondylitis and lupus, the prospect of having children brings many questions about health and medicines.

    They wonder if and how their disease may affect their fertility; if and how their autoimmune condition may affect their pregnancy; whether medicines taken for their disease before and during pregnancy might affect their baby; how pregnancy may affect their disease during and after the pregnancy itself; whether breastfeeding is advisable – and many more such questions, all of which can be very scary and worrying.

    Why is this such an important issue? Take rheumatoid arthritis, for example. The disease can strike at any time and affects both genders. But it is often diagnosed in middle age (typically between 30 and 60 years) and is typically much more frequent in women than men. In up to one woman in five, it may start before the age of 30.

    For a woman dealing with the news that she has rheumatoid arthritis, her mind may quickly turn to how this will impact her family or family plans. In the past, she may have been left with more questions than answers.

    The US Food & Drug Administration has published changes to the labeling regulations for pregnancy, lactation, and reproductive potential. This ‘Pregnancy and Lactation Labeling Final Rule (PLLR)’ sets new standards for how information about using medicines during pregnancy and breastfeeding is presented in the labeling of prescription drugs and biological products in the US. The aim is to provide a more consistent, useful and organized way to include more relevant information about the benefits and risks of prescription drugs and biological products used during pregnancy and breastfeeding.

    This, coupled with forthcoming presentations at EULAR, recently published “Points to consider for use of anti-rheumatic drugs before and during pregnancy and lactation” from a EULAR (European League Against Rheumatism) taskforce on reproduction and pregnancy in rheumatic diseases and recent publications in Europe such as the article by Østensen et al., “State of the art: Reproduction and pregnancy in rheumatic diseases”, means that the standards of care for women with immunological disorders are rising on both sides of the Atlantic.

    UCB took the decision to launch an initiative in 2012 focused on Family Planning and Pregnancy in Immunological Diseases. The goal was to enhance awareness and improve understanding, thus stimulating research and encouraging meaningful discussions between patients and physicians.

    In doing this we were stepping up to play an important role in an area where we could see leadership was required, because for decades there had not been enough attention for these very real issues that patients were facing. This is an issue that we understand well because it affects the lives of many of the patients we strive to support. We knew, from listening to healthcare professionals, patients and their families that working on this topic would be of considerable value.

    We are pleased that we took the initiative three years ago and are committed to keeping this issue on the agenda so that standards of research, knowledge and practice may continue to rise and help improve the lives of both women and men, living with immunological and other severe diseases. The topic of medicines and pregnancy is now on the map and we intend to continue contributing to this important endeavour.

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