RA in Pregnancy — SCE Rheumatology MCQ
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Correct answer: D — Continue hydroxychloroquine and use a breastfeeding-compatible alternative to methotrexate
Explanation lettering: C = shown as A · D = shown as C · A = shown as D
A is correct. Hydroxychloroquine is breastfeeding-compatible, whereas methotrexate should not be used. A compatible alternative can be selected according to postpartum disease activity. B and D preserve the contraindicated drug. C assumes low dose removes infant exposure concerns. E unnecessarily withdraws a compatible foundational therapy and risks a postpartum flare.
Reference: BSR guideline on immunomodulatory anti-rheumatic drugs in pregnancy and breastfeeding: https://academic.oup.com/rheumatology/article/62/4/1370/6783014