Treatment of RA: pregnancy category

Question 1

Methotrexate

Answer 1

X; Fetal abnormalities and abortifacient

Question 2

Sulfasalazine

Answer 2

B during pregnancy; D at term; caution in breastfeeding

Question 3

Leflunomide

Answer 3

X; Teratogenic; prior to pregnancy, drug elimination procedure with cholestyramine should be used until plasma concentration < 0.02 mg/L; Cholestyramine 8 g TID x 11d; activated charcoal is less effective alternative

Question 4

Hydroxychloroquine

Answer 4

C; generally considered safe in pregnancy

Question 5

Minocycline

Answer 5

D

Question 6

Azathioprine

Answer 6

D; considered safe in pregnancy because fetal liver cannot metabolize drug into the active form

Question 7

Cyclophosphamide

Answer 7

D

Question 8

Etanercept (Enbrel)

Answer 8

B

Question 9

Infliximab (Remicade)

Answer 9

B

Question 10

Adalimumab (Humira)

Answer 10

B

Question 11

Golimumab (Simponi)

Answer 11

B

Question 12

Certolizumab pegol (Cimzia)

Answer 12

B; lacks Fc potion so may be safer to use in pregnancy

Question 13

Rituximab (Rituxan)

Answer 13

C

Question 14

Abatacept (Orencia)

Answer 14

C

Question 15

Tocilizumab (Actemra)

Answer 15

C

Question 16

Anakinra (Kineret)

Answer 16

B