Meet Monica, a 28-year-old patient with severe active progressive RA,1 who recently found out that many RA treatments could interfere with family planning.2
‘This diagnosis couldn't have happened at a worse time – we both really want to start having children soon’.
‘I want to feel better, and don’t want this to get worse, but I’ve heard that some treatments for RA can be risky if taken while pregnant.2’
The decision on drug therapy during pregnancy and lactation should be based on agreement between the internist/rheumatologist, gynaecologist/obstetrician and the patient.2 The half-life needs to be taken into account when selecting a TNFi for women of fertile age. Published EULAR guidance2,*
Note: This is a hypothetical case for representation purpose only.
Patients such as Monica, who may need to interrupt treatment, benefit from the flexibility of Enbrel® monotherapy1,2,†
TNFi therapies indicated for RA1,3-6
Adapted from Enbrel® LPD. Version LPDENB062021; Götestam Skorpen C, et al. 2016; Remicade SmPC; Simponi SmPC; Humira SmPC; Cimzia SmPC.
Enbrel® should only be used during pregnancy if clearly needed. Women with childbearing potential should be advised to use appropriate contraception to avoid becoming pregnant during Enbrel® therapy and for 3 weeks after discontinuation of therapy. Because immunoglobulins, in common with many medicinal products, can be excreted in human milk, a decision must be made whether to discontinue breastfeeding or to discontinue Enbrel® therapy, taking into account the benefit of breastfeeding for the child and the benefit of therapy for the woman.1
Please consult the LPD for contraindications, warnings, precautions and other important safety information.
Please note: The examples described here are not of actual patients, but fictitious representations of scenarios for which Enbrel® (etanercept) could be considered.
*EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation.
†Enbrel can be used in MTX-intolerant patients, in patients not responsive to MTX as well as in MTX-naïve patients with severe, active and progressive disease.1
‡Mean half-life. Range: 7 to 300 hours.1
§Median half-life. Range: 8 to 9.5 days.3
AE, adverse event; AS, ankylosing spondylitis; EULAR, European Alliance of Associations for Rheumatology; LPD, local product document; JIA, juvenile idiopathic arthritis; MTX, methotrexate; PsA, psoriatic arthritis; PsO, psoriasis; RA, rheumatoid arthritis; SmPC, summary of product characteristics; TNFi, tumour necrosis factor inhibitor.
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https://cdsco.gov.in/opencms/export/sites/CDSCO_WEB/Pdf-documents/acts_rules/2016DrugsandCosmeticsAct1940Rules1945.pdf , Page No. 39, Rule 2 part (ee), last accessed on 13th September 2019.
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