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Factors for low disease activity identified in pregnant women with RA
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Women with rheumatoid arthritis who had low disease activity based on C-reactive protein levels or who had not taken prednisone in their first trimester had a likelihood of low disease activity in their third trimester, according to published study results.
Hilal Ince-Askan, MD, of the Erasmus Medical Center, Rotterdam, the Netherlands, and colleagues conducted a study that was embedded in the Pregnancy-Induced Amelioration of Rheumatoid Arthritis study, a nationwide prospective study from the Netherlands. There were 369 women with rheumatoid arthritis (RA) enrolled in the study. Participants wished to conceive or were already pregnant. During the study period from 2002 to 2008, 205 of the women conceived at least once. Analysis data included 190 pregnancies from 168 women (mean age of mother in first trimester, 32.2 years).
DAS28 using C-reactive protein (CRP) level (DAS28-CRP-3), prednisone use during the first trimester and autoantibody presence had a negative association with low disease activity in the third trimester (DAS28-CRP-3 < 3.2), according to results of multivariate regression models. Women with moderate to high disease activity in the first trimester (DAS28-CRP-3 3.2) had an association with prednisone use and presence of autoantibodies, according to subgroup analysis.
“Our study shows that a low initial DAS28-CRP-3 (preconception or first trimester), the absence of autoantibodies and the absence of prednisone use at pre-conception or in the first trimester are associated with low disease activity in the third trimester,” the researchers concluded. ‘These findings create more insight into the phenomenon of spontaneous improvement of RA during pregnancy and can be helpful in the daily care for our pregnant RA patients.” – Bruce Thiel
Disclosures: Ince-Askan reports no relevant financial disclosures. Please see the study for a full list of the other researchers’ relevant financial disclosures.
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