P13 DMARD Preconception Counseling and Reinforcement Should Be a Norm in All Rheumatology Clinics

The article discusses the importance of preconception counseling and reinforcement of contraceptive use for women of reproductive age who are on disease-modifying antirheumatic drugs (DMARDs) like leflunomide, which is known to be teratogenic in animal studies. It presents a case of a 36-year-old woman with rheumatoid arthritis who became pregnant while on leflunomide, highlighting the need for close monitoring and a multidisciplinary approach to manage such pregnancies. Despite the lack of strong human data on leflunomide's teratogenicity, the article emphasizes erring on the side of caution and the necessity of reinforcing contraceptive advice to prevent unplanned pregnancies. The case concluded with the delivery of a healthy baby, and the patient was counseled on the importance of contraception upon resuming leflunomide.