RA|研究进展 | 患有类风湿关节炎的育龄妇女的避孕药使用研究|使用|避孕|

摘自：中华风湿

本文图片
患有类风湿关节炎的
育龄妇女的避孕药使
目
的：
类风湿关节炎（RA）是一种复杂的疾病，可能需要使用一种或几种改善病情的抗风湿药物（DMARDs）进行治疗。许多DMARD具有潜在的致畸作用，或是妊娠期安全数据有限的较新的制剂。本研究评估了20种常见的RA药物以及具有生育能力、患有RA女性的避孕药使用情况和咨询情况。
方
法：
这是一项观察性研究，对象是2014年4月1日至2016年3月31日在一家学术风湿病诊所就诊的18至44岁患有RA ，并有生育能力的女性。研究使用描述性统计和单变量逻辑回归开展研究。
结
果：
本研究纳入150名女性。大多数患者服用甲氨蝶呤（55.3%），其次是慢性强的松（31.3%）和羟基氯奎因（28.7%）。 64/150（42.7%）中进行了避孕。对于避孕的妇女，最常用的联合口服避孕药（31/64 ， 48.4%）或左旋内宫设备（10/64 ， 15.6%）。在86名未避孕的患者中， 19名（22.1%）接受过有关怀孕计划的咨询。
结
论：
大多数具有育龄和能力的RA的妇女均未使用避孕药。在这些患者中，只有少数使用DMARD治疗的患者怀孕或进行了避孕咨询。使用DMARD的RA女性，如果有性生活，不希望怀孕或想避免婴儿致畸，应考虑有效避孕。本研究讨论了改善这一人群的医疗服务的潜在策略，以期避免意外怀孕和RA药物的潜在致畸作用。
原文
Contraceptive Use in Women of Childbearing Ability With Rheumatoid Arthritis
Objective
【RA|研究进展 | 患有类风湿关节炎的育龄妇女的避孕药使用】Rheumatoid arthritis (RA) is a complex disease that may require treatment with one or several disease-modifying antirheumatic drugs (DMARDs). Many DMARDs have potential teratogenic effects or are newer agents with limited safety data in pregnancy. This study evaluated 20 common RA medications and the rate of contraceptive prescribing and counseling patterns in women with RA of childbearing ability.
Methods
This was an observational study of women with RA and childbearing ability aged 18 to 44 years who were seen at an academic rheumatology clinic from April 1, 2014, to March 31, 2016. Descriptive statistics and univariate logistic regression were used for analysis.
Results
One hundred fifty women were included in the analysis. The majority of patients were taking methotrexate (55.3%), followed by chronic prednisone (31.3%) and hydroxychloroquine (28.7%). A documented method of contraception was noted in 64/150 (42.7%). For women on contraception, most used combined oral contraceptives (31/64, 48.4%) or levonorgestrel intrauterine device (10/64, 15.6%). Of the 86 patients not on contraception, 19 (22.1%) received counseling regarding a pregnancy plan.
Conclusion
Most women with RA of childbearing age and ability were not using contraception. Among these patients, only a minority prescribed DMARD therapy had documented pregnancy or contraceptive counseling. Women with RA who were prescribed with a DMARD should discuss the use of effective contraception with their provider if sexually active and not desiring pregnancy or wanting to avoid potential teratogenic effects. Potential strategies are discussed to improve healthcare delivery to this population in hopes of avoiding unintended pregnancy and potential teratogenic effects of RA medications.分页标题
文章出处:
doi: 10.1097/RHU.0000000000001184
作者：Ingram, Emily PharmD; Claus, Liza PharmD, BCACP; Kolfenbach, Jason MD; Wright, Garth MPH; et al.
杂志：JCR: Journal of Clinical Rheumatology: November 19, 2019 - Volume Publish Ahead of Print - Issue -
日期：2019.11.19
▼