[Overview of the new EULAR recommendations on antirheumatic therapy in reproduction, pregnancy and lactation]

In April 2025, the European Alliance of Associations for Rheumatology (EULAR) published recommendations on the use of antirheumatic drugs in the reproductive phase, during pregnancy and while breastfeeding. The previous EULAR Points to Consider from 2016 were updated and replaced. The task force formulated five overarching principles and twelve recommendations for the use of antirheumatic drugs before and during pregnancy, while breastfeeding and in male patients. The overarching principles emphasise the great importance of effective control of disease activity during pregnancy and breastfeeding to protect mother and child. In contrast to the 2016 version, biologics, especially tumour necrosis factor inhibitors, are considered safe both during pregnancy and breastfeeding. On the other hand, greater caution is recommended when using nonsteroidal anti-inflammatory drugs and glucocorticoids, especially in higher doses and over longer periods of time. New recommendations have been included for antirheumatic drugs and male fertility as well as for vaccinations in infants after intrauterine exposure to biologics. This "Hot Topic" summarises the EULAR recommendations for German rheumatologists.