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Abortion rates lower among women with RA taking methotrexate than other unexposed patients
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Women with rheumatoid arthritis who treated with methotrexate had lower rates for induced abortions compared with women with the disease not exposed to the drug, according to recent study results.
“Women with RA who become pregnant may have disease-specific reasons which might influence their decision to end a pregnancy,” researcher Évelyne Vinet, MD, at Montreal General Hospital of McGill University Health Centre, Canada, said in a press release. “Exposure to teratogenic drugs, such as [methotrexate], which can affect the development of the fetus, is one such reason women with RA may choose an induced abortion.”
Vinet and colleagues used Quebec’s administrative databases from 1996 to 2008 to perform a nested case-control study identifying all women with rheumatoid arthritis (RA) aged 15 to 45 years (n=18,654), with cases identified for women having an induced abortion. One or more controls were matched for age, calendar time and cohort entry to each case. Methotrexate (MTX) exposure was defined as having filled at least one prescription within 16 weeks of abortion.
There were 112 induced abortions among women with RA (mean age, 29.4 years; mean disease duration, 4.1 years) and 5,855 RA controls (mean age, 33.6 years; mean disease duration, 4.6 years). Among abortion cases, 10.7% had MTX exposure compared with 21.7% of controls.
“Women exposed to MTX had a lower [adjusted] rate of induced abortions compared to unexposed women (RR=0.47; 95% CI, 0.25-0.89),” the researchers reported.
Among women with RA exposed to anti-tumor necrosis factor (TNF) agents, there was a trend for an increased rate of induced abortions (RR=2.07; 95% CI, 0.81-5.27), according to multivariate analysis.
“These findings highlight the importance of research on reducing the number of unplanned pregnancies in women with RA taking MTX or TNF inhibitors,” Vinet said. “Further examination of counseling practices and contraceptive use is warranted.”
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