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Oligoarticular JIA — SCE Rheumatology MCQ

Instant feedback + full explanation. One question, done properly.

HardPaediatric RheumatologyOligoarticular JIASCE Rheumatology

A man with psoriatic arthritis controlled on methotrexate 20 mg weekly plans to father a pregnancy. His partner has no relevant medical problem. Which statement reflects current BSR guidance?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Paternal exposure to low-dose methotrexate up to 25 mg weekly is compatible with pregnancy

Explanation lettering: B = shown as A · D = shown as B · E = shown as C · A = shown as D · C = shown as E

D is correct. BSR found no increased adverse fetal outcomes in the available paternal-exposure cohorts and considers paternal low-dose methotrexate, defined as 25 mg weekly or less, compatible with pregnancy. Maternal methotrexate is different and must be stopped before conception. Unnecessary withdrawal in the father can destabilise disease, while switching to leflunomide adds toxicity and offers no reproductive advantage. Fertility concerns and individual product information can still be discussed, but they do not change the BSR compatibility statement.

Reference: BSR guideline on prescribing immunomodulatory anti-rheumatic drugs in pregnancy and breastfeeding: https://academic.oup.com/rheumatology/article/62/4/1370/6783014