Pregnancy and drugs

Hi all , im confused and would like some advice or help from someone who has been in my situation. Before i start i will just let you know a bit about my story . Ive had psoriasis since i was 11 yrs old then after i had my second child in 2000 i became ill with PA. Which was in almost every joint. I hve been on Methotrexate , sulfasalazine and hydroxychloriquine as a comnbination therapy which seemed to halt the flare and last year we decided to try for a baby and came off methotrexate and hydroxychloriquine just staying on sulfasalazine. In late August after being free of methotrexate for 6 months we caught pregnant but at 7 weeks we miscarried. We tried again and in January 2012 we were pregnant again but miscarried at 17 weeks pregnant . They havent found a reason for either miscrriage but i was told that my immune system might be to blame.

After the last miscarriage in april my bones have gone really bad , as we want to try again we've stayed off methotrexate but the rheumatologist said im ok to take sulfasalazine prednisolone and hydroxychloriquine while we re trying (which im currently on , but its not controled or helped in any way at the moment) i also have a shot of kenalog yesterday so hoping that will kick in and help soon .

Has anyone took similar drugs during pregnancy and had a healthy baby , im so stressed out about it all which isnt helping but im worried if we carry on waiting my bones are just going to get worse. Im 34 at the moment so time isnt really on my side and my husband doesnt have any children of his own , he is step-dad to my children who are 13 nd 12 years old. Ps i didnt have the arthritis with the other children as it came on after my youngest was born

thanks in advance , Nicci

Hi Nicci!

I'm so sorry to hear about your losses!

I'm on vacation (camping - with limited internet access!) and don't have my resources with me, but it's worth having your doctor look up the drugs and their effects on pregnancy. It isn't uncommon for women with PsA to miscarry, unfortunately. I miscarried twins a couple years ago, I think because of the start of a major PsA flare - the one that led to my diagnosis.

We won't be home until Monday - but if you don't get answers to your questions by then, please message me or bump this post and I'll see what my resources have to say about the drugs and pregnancy.

Hi Nicci,

I am no help on the drugs and pregnancy from experience. I was only able to have one child, and had no symptoms of PsA way back then that I know of. Sounds like nym will be your girl on this one. I would like to wish you well though. You make a lovely family, great photo!

Wishing you well!

Hugs,

SK

Thanks so much everyone , Nym if you have ny further info it would be so appreciated . Im really struggling lately .. also if you have any info about miscarriage and auto immune disease id be greatful . The gynea doc said Auto immune diseases can cause it but when i asked my Rheumy they brushed it off saying No ?? its confusing

http://www.everydayhealth.com/arthritis/understanding/the-immune-system.aspx

http://www.arthritistoday.org/daily-living/pregnancy-and-arthritis/safe-medications-during-pregnancy.php

http://www.arthritistoday.org/daily-living/pregnancy-and-arthritis/safe-medications-during-pregnancy.php

Twinkle, this is what I could find, let me know if I can help you with anything else.

Wishing you well,

SK

According to Medications and Mothers' Milk 2010, Thomas W. Hale, Ph.D.:

Sulfasalazine: Pregnancy risk category B: Either animal-reproduction studies have not demonstrated a fetal risk, but there are no controlled studies in pregnant women, or animal reproduction studies have shown an adverse effect (other than a decreasein fertility) that was not confirmed in controlled studies in women in the first trimester (and there is no evidence of a risk in later trimesters).

Prednisone- Prednisolone is a category C pregnancy risk: Either studies in animals have revealed adverse effects on the fetus (teratogenic or embryocidal, or other) and there are no controlled studies in women, or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the fetus.

Hydroxychloroquine is also a category C pregnancy risk.

I'll try to find more info later - right now I have a "remicade hangover", am wrangling my five kids, and have to go to a Sunday School planning meeting (taking the kids!).

thanks so much , i see rheumy on 7th august for second assessment for biologics.... altho she said i will have to come off it as soon as we get pregnant :(