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Journal article
2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases
ARTHRITIS & RHEUMATOLOGY, v 72(4), pp 529-556
Apr 2020
PMID: 32090480
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objective : To develop an evidence-based guideline on contraception, assisted reproductive technologies (ART), fertility preservation with gonadotoxic therapy, use of menopausal hormone replacement therapy (HRT), pregnancy assessment and management, and medication use in patients with rheumatic and musculoskeletal disease (RMD).
Methods : We conducted a systematic review of evidence relating to contraception, ART, fertility preservation, HRT, pregnancy and lactation, and medication use in RMD populations, using Grading of Recommendations Assessment, Development and Evaluation methodology to rate the quality of evidence and a group consensus process to determine final recommendations and grade their strength (conditional or strong). Good practice statements were agreed upon when indirect evidence was sufficiently compelling that a formal vote was unnecessary.
Results : This American College of Rheumatology guideline provides 12 ungraded good practice statements and 131 graded recommendations for reproductive health care in RMD patients. These recommendations are intended to guide care for all patients with RMD, except where indicated as being specific for patients with systemic lupus erythematosus, those positive for antiphospholipid antibody, and/or those positive for anti-Ro/SSA and/or anti-La/SSB antibodies. Recommendations and good practice statements support several guiding principles: use of safe and effective contraception to prevent unplanned pregnancy, pre-pregnancy counseling to encourage conception during periods of disease quiescence and while receiving pregnancy-compatible medications, and ongoing physician-patient discussion with obstetrics/gynecology collaboration for all reproductive health issues, given the overall low level of available evidence that relates specifically to RMD.
Conclusion : This guideline provides evidence-based recommendations developed and reviewed by panels of experts and RMD patients. Many recommendations are conditional, reflecting a lack of data or low-level data. We intend that this guideline be used to inform a shared decision-making process between patients and their physicians on issues related to reproductive health that incorporates patients' values, preferences, and comorbidities.
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Details
- Title
- 2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases
- Creators
- Lisa R. Sammaritano - Hospital for Special SurgeryBonnie L. Bermas - The University of Texas Southwestern Medical CenterEliza E. Chakravarty - Oklahoma Medical Research FoundationChristina Chambers - University of California San DiegoMegan E. B. Clowse - Duke Medical CenterMichael D. Lockshin - Hospital for Special SurgeryWendy Marder - University of MichiganGordon Guyatt - McMaster Univ, Hamilton, ON, CanadaD. Ware Branch - University of UtahJill Buyon - New York UniversityLisa Christopher-Stine - Johns Hopkins MedicineRachelle Crow-HercherJohn Cush - Baylor Res Inst, Dallas, TX USAMaurice Druzin - Stanford MedicineArthur Kavanaugh - Univ Calif San Diego, La Jolla, CA 92093 USACarl A. Laskin - University of TorontoLauren Plante - Drexel Univ, Coll Med, Philadelphia, PA 19104 USAJane Salmon - Hospital for Special SurgeryJulia Simard - Stanford MedicineEmily C. Somers - University of MichiganVirginia Steen - Georgetown University Medical CenterSara K. Tedeschi - Brigham and Women's HospitalEvelyne Vinet - McGill University Health CentreC. Whitney White - University of MississippiJinoos Yazdany - Univ Calif San Francisco, San Francisco, CA 94143 USAMedha Barbhaiya - Hospital for Special SurgeryBrittany Bettendorf - University of IowaAmanda Eudy - Duke Medical CenterArundathi Jayatilleke - Drexel UniversityAmit Aakash Shah - American College of RheumatologyNancy Sullivan - ECRI InstituteLaura L. Tarter - Brigham and Women's HospitalMehret Birru Talabi - University of PittsburghMarat Turgunbaev - American College of RheumatologyAmy Turner - American College of RheumatologyKristen E. D'Anci - ECRI Institute
- Publication Details
- ARTHRITIS & RHEUMATOLOGY, v 72(4), pp 529-556
- Publisher
- WILEY; HOBOKEN
- Number of pages
- 28
- Grant note
- Supported by the American College of Rheumatology.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:000515077600001
- Scopus ID
- 2-s2.0-85081562754
- Other Identifier
- 991021860782204721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Rheumatology