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[Active psoriatic arthritis during pregnancy: challenges and limitations of pharmacotherapy]
Agnieszka Matuszewska1, Maria Misterska-Skóra, Piotr Wiland
1Klinika Reumatologii i Chorób Wewnetrznych Akademickiego Szpitala Klinicznego im. Mikulicza-Radeckiego ul. Borowska 213, 50-556 Wrocław.
Abstract:
Cases of psoriatic arthritis coexisting with pregnancy are sparse and therefore little is known about the fetal effect of medication in women with psoriatic arthritis. As a rule, drugs and dosages are minimized in these patients. Among disease-modifying antirheumatic drugs, cyclosporine and sulphasalazine are preferred. Methotrexate and leflunomide are strictly contraindicated and must be withdrawn 3 months or 2 years, respectively, before a pregnancy is planned. Psoriatic arthritis may be treated during pregnancy with glucocorticosteroids, especially with prednisone or prednisolone. We present the case ofa 40-year-old gravida with psoriatic arthritis which exacerbated during the first trimester of pregnancy. Therapeutic implications in such cases are discussed.
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