medwireNews: The ACR has released guidelines for reproductive healthcare among people with rheumatic and musculoskeletal diseases (RMD).
“This guideline’s most important goal is to provide substance and direction for discussion between clinicians and patients,” and a “second goal is to encourage development of close working relationships” among rheumatology, obstetrics/gynecology, maternal–fetal medicine, and fertility specialists, say Lisa Sammaritano (Hospital for Special Surgery, New York, USA) and co-authors.
The guidelines, published simultaneously in Arthritis & Rheumatology and Arthritis Care & Research, provide twelve good practice statements and 131 graded recommendations covering contraception use, pre-pregnancy counselling, and regular physician–patient communication.
Sammaritano and colleagues note that “[t]he strength of evidence on reproductive health topics in RMD patients is moderate at best, and usually low, very low or nonexistent for many topics of interest,” and outline priorities for future research, which should include better understanding of the effects of RMD medication on male fertility, and large-scale studies on RMD drug use in women around the time of pregnancy.
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Arthritis Rheumatol 2020; doi:10.1002/art.41191
Arthritis Care Res 2020; doi:10.1002/acr.24130