Mod Rheumatol. 2025 Oct 8:roaf087. doi: 10.1093/mr/roaf087. Online ahead of print.
ABSTRACT
OBJECTIVES: To inform the 2024 updates of the Japanese College of Rheumatology clinical practice guidelines for the management of rheumatoid arthritis (RA) of the safety of maternal and paternal exposure to disease-modifying antirheumatic drugs (DMARDs).
METHODS: We searched the databases of PubMed, the Cochrane Library, and the Japana Centra Revuo Medicina for articles published between 2019 and 2022 and combined them with our previous systematic review. Two independent reviewers screened articles, evaluated core outcomes, and performed meta-analyses for each clinical question.
RESULTS: The relative effects (odds ratio (OR) [95% confidence interval (95% CI)]) of tumour necrosis factor inhibitor (TNFi) exposure on the infants of pregnant women with RA were as follows: major birth defects, 1.51 [0.89, 2.58]); and serious neonatal infections, 1.20 [0.84, 1.71]. For the relative effect (OR [95% CI]) of paternal antirheumatic drugs exposure on major birth defect of their infants were1.3 [0.28, 6.14] for TNFi and 0.94 [0.38, 2.33] for methotrexate.
CONCLUSIONS: This systematic review provided the latest evidence on effects of maternal and paternal exposure to DMARDs on their infants for the 2024 update of the CPG.
PMID:41060311 | DOI:10.1093/mr/roaf087
