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AMERICAN COLLEGE OF RHEUMATOLOGY PRESENTS DRAFT OF FIRST GUIDELINE ON REPRODUCTIVE HEALTH IN RHEUMATIC DISEASES
Newswise — CHICAGO – The American College of Rheumatology (ACR) will present the draft of a new clinical practice guideline for the management of reproductive health in patients with rheumatic diseases during a session at the 2018 ACR/ARHP Annual Meeting this week at McCormick Place in Chicago. The Reproductive Health in Rheumatic Diseases Guideline is the first evidence-based, clinical practice guideline related to the management of all reproductive health issues for patients across the spectrum of rheumatic diseases.
The session will take place on Tuesday, Oct. 23, at 2:45 PM (CT) in W375b and will include a presentation by Lisa R. Sammaritano, MD, Associate Professor of Clinical Medicine at Hospital for Special Surgery-Weill Cornell Medicine in New York, N.Y. Dr. Sammaritano is the Principal Investigator and Voting Panel Leader of the Core Oversight Team of experts who oversaw the development of the new guideline. Dr. Sammaritano will also discuss the new guideline at a press conference that will take place on Tuesday, Oct. 23, at 12:30 PT (CT) in W175a.
Dr. Sammaritano shared that managing pregnancy, especially in women with conditions like lupus or antiphospholipid antibody syndrome, can be challenging, so this guideline is timely and important.
“The issue of pregnancy has become of increasing interest to rheumatologists and our patients over the years, especially because patients with rheumatic diseases are able to safely pursue pregnancy more often now than in the past,” she says. “Our patients have particular needs and challenges during pregnancy, and the obstetrician/gynecologist may not always be aware of these. In addition, rheumatologists may not be aware of updates in contraception, fertility therapies and pregnancy management. With the expansion of new therapies available for rheumatic diseases in recent years, especially in rheumatoid arthritis, we need to learn more about which of these new treatments are compatible with pregnancy.”
Both women and men may face reproductive or family planning issues related to their rheumatic disease or therapy. Ideally, women with autoimmune and inflammatory diseases should plan their pregnancies ahead of time and conceive during periods of low disease activity, or when neither the mother nor father are using teratogenic medications, which could put the fetus at risk. Patients often seek guidance from their rheumatologists on safe contraception, fertility issues, or safe medication use during pregnancy or breastfeeding. This guideline will serve as a helpful tool to assist the rheumatologist in making recommendations to patients about family planning.
“The guiding principle for the guideline is to develop better dialogue between the rheumatologist and patient, as well as between the rheumatologist and other involved physicians,” says Dr. Sammaritano. At a meeting with a panel of patients to help develop the guideline, “the main comment we heard was that patients want to talk with their rheumatologist about family planning, early and often.”
Panelists developing the new guideline include rheumatologists, obstetrician/gynecologists, reproductive medicine specialists, epidemiologists, and patients with rheumatic diseases. They conducted a systematic review of current, evidence-based literature on all aspects of reproductive health in rheumatic disease and assessed the quality of the evidence using standard (GRADE) methodology. When the guideline is complete, it will likely be divided into three separate papers. The first will cover reproductive health in general, including contraception, assisted reproductive technology, preservation of fertility for women using cytotoxic medications, and menopause, including estrogen replacement therapy. The second paper will focus on pregnancy counseling and management. The third paper will cover medication management, including paternal use and maternal use during pregnancy, and breastfeeding.
“An increasing number of studies have identified important risk factors for adverse pregnancy outcomes in women with rheumatic diseases,” says Dr. Sammaritano. “Rheumatologists know much more now about who is at greatest risk for complications, and we can counsel these patients so they can weigh the risks and the benefits of each decision and manage them according to their risk profile. We hope this guideline will be useful to rheumatologists and help physicians in all aspects of reproductive health have discussions with their patients.”
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About the ACR/ARHP Annual Meeting
The ACR/ARHP Annual Meeting is the premier meeting in rheumatology. With more than 450 sessions and thousands of abstracts, if offers a superior combination of basic science, clinical science, tech-med courses, career enhancement education and interactive discussions on improving patient care. For more information about the meeting, visit https://www.rheumatology.org/Annual-Meeting, or join the conversation on Twitter by following the official #ACR18 hashtag.
About the American College of Rheumatology
The American College of Rheumatology is an international medical society representing over 9,400 rheumatologists and rheumatology health professionals with a mission to empower rheumatology professionals to excel in their specialty. In doing so, the ACR offers education, research, advocacy and practice management support to help its members continue their innovative work and provide quality patient care. Rheumatologists are experts in the diagnosis, management and treatment of more than 100 different types of arthritis and rheumatic diseases. For more information, visit www.rheumatology.org.
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