Patterns of Medication Use Before, During, and After Pregnancy in Women with Systemic Lupus Erythematosus : A Population-Based Cohort Study
department or school: Medicine, Faculty of
department or school: Pharmaceutical Sciences, Faculty of
department or school: Other UBC
department or school: Non UBC
department or school: Medicine, Department of
data provider: DSpace
identifier citation: Zusman E, Sayre EC, Aviña-Zubieta JA, De Vera MA. Patterns of Medication Use Before, During, and After Pregnancy in Women with Systemic Lupus Erythematosus: A Population-Based Cohort Study. Lupus. 2019 Jul 16:961203319863111.
contributor: University of British Columbia. Collaboration for Outcomes Research and Evaluation
creator: Zusman, Enav Zipora
creator: Sayre, E. C.
creator: Aviña-Zubieta, J. Antonio
creator: De Vera, Mary
issued: 2020-01-08T17:18:40Z
issued: 2019-07
description: Objectives: This study aimed to characterize the patterns of medication use before, during and after pregnancy in a population-based cohort of women with systemic lupus erythematosus (SLE). Methods: Using population-based administrative data in British Columbia, Canada with valid information on start date of pregnancy, we identified women with SLE who had singleton pregnancies ending in deliveries between January 1st, 2002 and December 31st, 2012. We assessed the proportion of SLE pregnancies exposed to SLE medications – namely antimalarials and immunosuppressants – as well as glucocorticosteroids, and nonsteroidal anti-inflammatory drugs (NSAIDs) 24 months before pregnancy, each trimester of pregnancy, and 12 months post-pregnancy. We also assessed discontinuation of antimalarials and immunosuppressants, defined as no prescriptions in a given window following a prescription in a preceding window. Results: Of 376 pregnancies (284 women) with SLE, 24.2% had one or more dispensing for antimalarials, 8.2% for azathioprine, 19.7% for glucocorticosteroids and 4.8% for NSAIDs during pregnancy. We observed 16.7% discontinuation of antimalarials in the year prior to pregnancy, 29.8% in the first trimester, 9.7% in the second trimester, and 26% in the third trimester. We also observed 29.2% discontinuation of azathioprine in the first trimester, 8% in the second trimester, and 9% in the third trimester. Conclusions: These population-based data show frequent discontinuation of medications, particularly antimalarials, in SLE pregnancies. Findings suggest the importance of educating women with SLE who are pregnant or planning to become pregnant on the benefits and risks of medications during pregnancy.
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/73208
note: 1 Patterns of Medication Use Before, During, and After Pregnancy in Women with Systemic Lupus Erythematosus: A Population-Based Cohort Study Authors: Enav Z. Zusman, MSc1,2,3; Eric C. Sayre, PhD3; J. Antonio Aviña-Zubieta, MD, PhD3,4; Mary A. De Vera, PhD1,2,3 Author affiliations: 1University of British Columbia Faculty of Pharmaceutical Sciences, Vancouver, Canada; 2Collaboration for Outcomes Research and Evaluation, Vancouver, Canada; 3Arthritis Research Canada, Richmond, BC, Canada; 4University of British Columbia Faculty of Medicine, Department of Medicine, Division of Rheumatology, Vancouver, Canada Key words: systemic lupus erythematosus, pregnancy, reproduction, medications Manuscript word count: 3297 Titles, funding, and grant support: Dr. De Vera holds a Canada Research Chair in Medication Adherence, Utilization, and Outcomes and is a Michael Smith Foundation for Health Research Scholar. Dr. Aviña-Zubieta is a Michael Smith Foundation for Health Research Scholar and the BC Lupus Society Scholar. 2 Ms. Zusman received financial support from Bong Pang Yee Endowment Fund for her work on this project. This research was funded by an operating grant from The Arthritis Society (YIO-13-07). Corresponding author: Mary A. De Vera, PhD University of British Columbia Faculty of Pharmaceutical Sciences 2405 Wesbrook Mall Vancouver, BC, V6T 1Z3 Tel: 604-221-8767; Email: mdevera@mail.ubc.ca ABSTRACT Objectives: This study aimed to characterize the patterns of medication use before, during and after pregnancy in a population-based cohort of women with systemic lupus erythematosus (SLE). Methods: Using population-based administrative data in British Columbia, Canada with valid information on start date of pregnancy, we identified women with SLE who had singleton pregnancies ending in deliveries between January 1st, 2002 and December 31st, 2012. We assessed the proportion of SLE pregnancies exposed to SLE medications – namely antimalarials and immunosuppressants – as well as…
has type: Article
has type: Postprint
is shown at: 10.14288/1.0387572
language: eng
peer review status: Reviewed
provider: Vancouver : University of British Columbia Library
publisher DOI: 10.1177/0961203319863111
rights: Attribution-NonCommercial-NoDerivatives 4.0 International
rights URI: http://creativecommons.org/licenses/by-nc-nd/4.0/
scholar level: Faculty
subject: Systemic lupus erythematosus
subject: Pregnancy
subject: Reproduction
subject: Medications
type: Text
identifier URI: http://hdl.handle.net/2429/73208