AB0302 USE OF TNF-INHIBITORS BEFORE, DURING AND THE FIRST YEAR AFTER PREGNANCY AMONG WOMEN WITH RHEUMATOID ARTHRITIS

Background: Treat to target is a goal, also in pregnant women with Rheumatoid arthritis (1). There is increasing evidence on safe use with TNF inhibitors during pregnancy. Adjusted use of TNF inhibitors preconception and throughout pregnancy may stabilize disease activity and prevent flares (2). Low disease activity is also beneficial for the fetus. Objectives: To study the use of TNF-inhibitors among women with Rheumatic arthritis during and after pregnancy. Methods: RevNatus is a Norwegian, nationwide quality register that monitors treatment of inflammatory rheumatic diseases before, during and after pregnancy. Data from RevNatus in the period October 2017 to October 2019 was used to map the use of all types of TNF inhibitors among 208 women with rheumatoid arthritis, diagnosed by the ACR/EULAR criteria. The use of medication was reported at the time of visit in outpatient clinic. The frequency of use of TNF inhibitors registered at seven timepoints from pre-pregnancy to twelve months after delivery. Results: The use of medication was reported at each visit for all the women with rheumatoid arthritis. Most of the women were not using TNF inhibitors before and beyond conception. Most of the women continuing TNF inhibitors beyond conception used certolizumab or etanercept. Adalimumab and infliximab were used in pregnancy (tabell 1 ). Tabell 1. certoliz-umab etane-rcept adalim-umab golim-umab inflixi-mab No TNF-inhibitor Before pregnancy n=105 21% (22) 9% (10) 3% (3) 1% (1) 66% (69) 1.trimester n=81 19% (15) 10% (8) 71% (58) 2.trimester n=88 10% (9) 10% (9) 80% (70) 3.trimester n=91 11% (10) 5% (5) 83% (76) 6 weeks post partum n=96 22% (21) 13% (13) 1% (1) 1% (1) 63% (60) 6 months post partum n=88 24% (21) 18% (16) 4% (4) 1% (1) 53% (46) 12 months post partum n=84 21% (18) 17% (15) 7% (6) 2% (2) 53% (43) Conclusion: Most of the women with rheumatic arthritis were not treated with TNF inhibitors before or in pregnancy. Women with rheumatic arthritis that continuing treatment with TNF inhibitors through pregnancy were using certilozumab and etanercept. References: [1]Gotestam Skorpen C, Hoeltzenbein M, Tincani A, Fischer-Betz R, Elefant E, Chambers C, et al. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. 2016;75(5):795-810. [2]van den Brandt S, Zbinden A, Baeten D, Villiger PM, Ostensen M, Forger F. Risk factors for flare and treatment of disease flares during pregnancy in rheumatoid arthritis and axial spondyloarthritis patients. Arthritis Res Ther. 2017;19(1):64. Disclosure of Interests: None declared