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Axial spondyloarthritis in pregnancy — SCE Rheumatology MCQ

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ModeratePregnancy in rheumatic disease, rare conditionsAxial spondyloarthritis in pregnancySCE Rheumatology

A 34-year-old woman with axial spondyloarthritis has severe disease controlled on certolizumab pegol and is 18 weeks pregnant. She has no infection and fetal growth is normal. What is the most appropriate management?

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Correct answer: D — Continue certolizumab if needed for maternal disease control

Certolizumab has minimal Fc-mediated placental transfer and is considered among the biologics most compatible with pregnancy when disease control is needed. Stopping effective therapy may provoke flare and steroid exposure. Methotrexate and leflunomide are not pregnancy-compatible DMARD choices.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/musculoskeletal-conditions