Data gives insights into treatment for RMD patients who wish to conceive

Spondyloarthritis (SpA) is one of the most common chronic inflammatory diseases and regularly affects women of childbearing age. Sabrina Hamroun presents new information at EULAR about the factors associated with time-to-conception in women with SpA. Of 88 women selected for analysis of time-to-conception, 63.6% had a clinical pregnancy during follow-up. Subfertility was observed in 45.4% and the median time-to-conception was 16.1 months in women followed prospectively from the wish to conceive.

A multivariate model found an association between longer time-to-conception and age, as well as the use of non-steroidal anti-inflammatory drugs (NSAIDs) during preconception. No association was found for body mass index, disease activity or duration, smoking, form of spondyloarthritis, or exposure to conventional systemic or biologic disease-modifying antirheumatic drugs (b/csDMARDs). These important findings point to a need for cautious use of NSAIDs in women with SpA who wish to become pregnant.

Methotrexate is one of the most frequently prescribed medications for the treatment of several RMDs. Although this agent has well-established safety and efficacy profiles, there is limited evidence to support its use in men who wish to conceive.

Dr. Luis Fernando Perez-Garcia and colleagues designed a study to evaluate semen parameters before and after exposure to methotrexate in 48 men with and without RMDs. This is the largest prospective study ever conducted to evaluate this topic.

The group looked at sperm concentration, volume, and progressive motility. The findings demonstrate that exposure to methotrexate did not result in significantly different semen parameters. The results suggest that methotrexate can be continued in men who wish to become a father.