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Prescribing of sulfasalazine, azathioprine and methotrexate round pregnancy—a descriptive study
Author(s) -
Vroom Fokaline,
van Roon Eric N.,
van den Berg Paul B.,
Brouwers Jacobus R.B.J.,
de Jongvan den Berg Lolkje T.W.
Publication year - 2008
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.1506
Subject(s) - medicine , pregnancy , sulfasalazine , discontinuation , pharmacoepidemiology , methotrexate , medical prescription , azathioprine , drug , pharmacotherapy , obstetrics , disease , pharmacology , genetics , ulcerative colitis , biology
Abstract Purpose Continuation or discontinuation of drugs during pregnancy in chronic diseases is an issue of concern. Information on prescribing of disease modifying anti‐rheumatic drugs (DMARDs) during pregnancy is scarce. In this study, we report prescribing patterns round pregnancy of sulfasalazine (SSZ), azathioprine (AZA), methotrexate (MTX) and co‐medications among women to whom one of these DMARDs were prescribed before pregnancy. Methods The pregnancy‐interaction database (IADB.nl, 1994–2004), containing pharmacy dispensing data from Northern‐ Netherlands, was used. Women to whom SSZ ( N = 13), AZA ( N = 10) or MTX ( N = 6) was prescribed before their first pregnancy were identified and described in detail. Results AZA and SSZ are continued during pregnancy by 60% and 38% of the women, respectively, MTX was stopped before pregnancy. Among women receiving SSZ ( N = 13) as their initial DMARD, anti‐inflammatory and anti‐rheumatic drugs (69%) and analgesics (45%) were the most commonly prescribed co‐medications. Among women receiving AZA ( N = 8) as their initial DMARD, corticosteroids for systemic use (100%) and intestinal anti‐inflammatory agents (88%) were the most commonly prescribed co‐medications. All women receiving intestinal anti‐inflammatory drugs before pregnancy continued this during pregnancy, in contrast to other co‐medications which were mainly discontinued. Conclusions Our study showed that DMARDs and co‐medication are received before, during and after pregnancy, although no specific prescription patterns were found. Administrative databases, such as the pregnancy‐IADB.nl, are useful in describing drug‐prescribing patterns for better understanding of drug prescribing around pregnancy in daily practice. Based on these data, we conclude that prescribing of DMARDs and related co‐medication is based on the individual patient. Copyright © 2007 John Wiley & Sons, Ltd.