Question-207

A couple came for they want to have a baby, the woman is a RA patient on methotrexate and sulfasalazine. Which regimen she should be on when she is pregnant ?


a. Continue both methotrexate and sulfa
b. Stop methotrexate and continue sulfa
c. Stop sulfa and continue methotrexate
d. Shift to Adalimumab
e. Shift to liflonumide

B - ?

http://www.nras.org.uk/about_rheumatoid_arthritis/living_with_rheumatoid_arthritis/relationships_pregnancy/rheumatoid_arthritis_pregnancy.aspx

If you're taking leflunomide for RA, even more advance planning is necessary. Due to its long half-life, leflunomide needs to be stopped two years before trying to conceive a baby, although there are ways to "wash" it out of your system quicker.

Low-dose prednisone, for example, is generally considered safe during pregnancy. Hydroxychloroquine (Plaquenil) and sulfasalazine are also considered safe. While evidence is limited for biologic medicines like Enbrel and Remicade, many rheumatologists are confident in their relative safety during pregnancy.

http://www.webmd.com/rheumatoid-arthritis/family-planning-and-rheumatoid-arthritis
The side effects of Humira (d) have not been study on pregnancy yet.so the correct answer is b