Therapeutic Regimen and Contraceptive Choice in Systemic Lupus Erythematosus Patients with Pregnancy Intendedness:a Case Report / 医药导报

ABSTRACT

Objective To explore the therapeutic regimens and contraception methods in systemic lupus erythematosus ( SLE) patients with planned pregnancy . Methods Case report of a SLE patient expecting her second child and review of relevant literature were presented. The prognosis for pregnancy in SLE patients was discussed, the safety profile of medications used to treat SLE during pregnancy was analyzed and the efficacy, side effects of different contraceptive methods were compared. Results For SLE patients with high disease activity, the use of progestin-only contraceptives were advised to avoid thromboembolic risk and risk of disease flare. Patients were usually treated with high doses of systemic glucocorticoids in combination with mycophenolate mofetil (induction therapy) to control the disease.Pregnancy should be avoided until the disease was inactive for at least six months with a low-dose glucocorticoid (eg, 5 to 15 mg of prednisone per day).Azathioprine (not exceed 2 mg·kg-1 ·d-1 ) for maintaining remission was considered relatively safe during pregnancy, the use of cyclosporine or tacrolimus may also be acceptable in patients intolerant to azathioprine. Conclusion Ideally, all pregnancies in patients with SLE should be planned during periods of disease quiescence for at least six months. The safety and efficacy of medications and contraceptive methods must be reviewed and adjusted prior to conception with the goal of maintaining disease control and optimizing maternal outcomes.