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Contraception methods used by women with rheumatoid arthritis and psoriatic arthritis

Author

Leverenz DL1, Eudy AM2, Jayasundara M2, Haroun T2, McDaniel G2, Benjamin Nowell W3, Curtis JR4, Crow-Hercher R3, White W3,5, Ginsberg S3, Clowse MEB2. Clin Rheumatol. 2019 Apr;38(4):1207-1212. doi: 10.1007/s10067-018-04420-1. Epub 2019 Jan 16.

Author Information

1 Division of Rheumatology & Immunology, Duke University Medical Center (DUMC), Box 2918, Durham, NC, 27710, USA. David.Leverenz@Duke.edu.

2 Division of Rheumatology & Immunology, Duke University Medical Center (DUMC), Box 2918, Durham, NC, 27710, USA.

3 Global Healthy Living Foundation, CreakyJoints, Upper Nyack, NY, USA.

4 Division of Clinical Immunology and Rheumatology, The University of Alabama at Birmingham, Birmingham, AL, USA.

5 Department of Pharmacy Practice, University of Mississippi, Jackson, MS, USA.

Abstract

Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are common in women of childbearing age and are often treated with teratogenic medications. In this study, we assessed contraceptive methods in young women with RA or PsA and correlated contraceptive method efficacy with use of concomitant rheumatic medications. We combined the data from several cross-sectional surveys of women under the age of 40 with RA or PsA. Two surveys recruited participants from a clinic setting (RA and PsA Clinic Surveys), and the third survey recruited participants from CreakyJoints.org , an online forum for patients with inflammatory arthritis (CreakyJoints Survey). Of the 164 women included, 138 had RA (67 in RA Clinic Survey, 71 in CreakyJoints Survey) and 26 had PsA (19 in PsA Clinic Survey, 7 in CreakyJoints Survey). Use of specific contraceptive and rheumatic medications were similar between the clinic and online surveys. In the pooled analysis of the Clinic and CreakyJoints survey data, women with RA and PsA reported similar utilization of highly effective contraception methods (31.9% RA, 34.6% PsA) and effective methods (31.2% RA, 30.8% PsA), but different utilization of ineffective methods (35.5% RA, 11.5% PsA) and no methods (1.5% RA, 23.1% PsA), p = 0.0002. These proportions remained similar across subgroups taking methotrexate, anti-TNF biologics, and novel medications. Approximately two thirds of women with RA and PsA reported using effective or highly effective methods of contraception, though women with PsA were more likely to report no methods of contraception.