{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T23:08:26Z","timestamp":1790291306409,"version":"4.1.0"},"reference-count":56,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T00:00:00Z","timestamp":1740355200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Targeted synthetic disease\u2010modifying antirheumatic drugs (tsDMARDs) have expanded the management of autoimmune diseases, including rheumatic diseases. As the use of these drugs grows, it is important to understand their effects on pregnancy. We conducted a scoping review to synthesize the current evidence on the impacts of tsDMARDs on pregnancy outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched the Embase, MEDLINE, and CENTRAL databases in November 2023. We included studies that examined tsDMARD exposure for chronic autoimmune disease(s), particularly in mothers during pregnancy, fathers before conception, and\/or fetuses\/neonates in utero. We extracted data on sample size, study design, tsDMARD exposure (dose and duration), and reproductive health outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 6,712 studies screened, eight were included, namely nine case reports, one case series, four cross\u2010sectional studies, and one cohort study among patients with ulcerative colitis, rheumatoid arthritis, and psoriasis. Sample sizes ranged from 1 to 116 pregnancies or offspring, with six studies on tofacitinib, one on baricitinib, one on upadacitinib, and no studies on apremilast. Overall, 19 fetal\/neonatal outcomes, six fetal\/neonatal\u2010maternal outcomes, and three maternal outcomes were extracted. The most frequently reported fetal\/neonatal outcomes were congenital anomaly (n = 4), preterm birth (n = 4), and the fetal\/neonatal\u2010maternal outcome of spontaneous abortion (n = 4). Only one study reported on the maternal outcome of delivery via Cesarean section.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our scoping review of evidence to date on the perinatal use of tsDMARDs reveal small sample sizes and a limited number of studies, all largely descriptive in nature. Findings highlight evidence gaps that preclude providers and patients from making informed decisions when considering the perinatal use of tsDMARDs.<\/jats:p><jats:p><jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/acr25502-toc-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.25502","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T01:21:07Z","timestamp":1738545667000},"page":"916-927","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Pregnancy Outcomes of Targeted Synthetic Disease\u2010Modifying Antirheumatic Drugs Among Patients With Autoimmune Diseases: A Scoping Review"],"prefix":"10.1002","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7053-559X","authenticated-orcid":false,"given":"Vienna","family":"Cheng","sequence":"first","affiliation":[{"name":"University of British Columbia, Collaboration for Outcomes Research and Evaluation, and Arthritis Research Canada  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2185-3347","authenticated-orcid":false,"given":"Neda","family":"Amiri","sequence":"additional","affiliation":[{"name":"University of British Columbia, Arthritis Research Canada, and Mary Pack Arthritis Centre  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5030-9135","authenticated-orcid":false,"given":"Vicki","family":"Cheng","sequence":"additional","affiliation":[{"name":"University of British Columbia and Collaboration for Outcomes Research and Evaluation  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5896-4852","authenticated-orcid":false,"given":"Ursula","family":"Ellis","sequence":"additional","affiliation":[{"name":"University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6284-938X","authenticated-orcid":false,"given":"Jacquelyn J.","family":"Cragg","sequence":"additional","affiliation":[{"name":"University of British Columbia, Collaboration for Outcomes Research and Evaluation, and International Collaboration on Repair Discoveries  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2115-2447","authenticated-orcid":false,"given":"Mark","family":"Harrison","sequence":"additional","affiliation":[{"name":"University of British Columbia, Collaboration for Outcomes Research and Evaluation, Arthritis Research Canada, and Centre for Health Evaluation and Outcome Sciences  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie","family":"Proulx","sequence":"additional","affiliation":[{"name":"Canadian Arthritis Patient Alliance  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2205-2683","authenticated-orcid":false,"given":"Mary A.","family":"De Vera","sequence":"additional","affiliation":[{"name":"University of British Columbia, Collaboration for Outcomes Research and Evaluation, Arthritis Research Canada, and Centre for Health Evaluation and Outcome Sciences  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-014-0174-6"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21663"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ket387"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1351.019"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keab544"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23124"},{"issue":"2","key":"e_1_2_6_8_1","first-page":"96","article-title":"Pregnancy and inflammatory bowel disease","volume":"11","author":"Hashash JG","year":"2015","journal-title":"Gastroenterol Hepatol (N Y)"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2022-002445"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23730"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-022-04185-9"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-006-0073-3"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2018.1498835"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(90)90617-A"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjaa026"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.24462"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.coph.2022.102234"},{"key":"e_1_2_6_18_1","volume-title":"Product monograph","author":"Otezla","year":"2020"},{"key":"e_1_2_6_19_1","volume-title":"Product monograph","author":"Xeljanz","year":"2014"},{"key":"e_1_2_6_20_1","volume-title":"Product monograph","author":"Olumiant","year":"2024"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells9081876"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.13103"},{"key":"e_1_2_6_23_1","volume-title":"StatPearls","author":"Benjamin O","year":"2024"},{"key":"e_1_2_6_24_1","unstructured":"Mother to Baby.Apremilast (Otezla).Organization of Teratology Information Specialists. Published February 1 2024. AccessedAugust 14 2024.https:\/\/mothertobaby.org\/fact-sheets\/apremilast\/"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.3390\/molecules25153321"},{"key":"e_1_2_6_26_1","unstructured":"US Food and Drug Administration.Drugs@FDA: FDA\u2010approved drugs. Accessed August 14 2024.https:\/\/www.accessdata.fda.gov\/scripts\/cder\/daf\/index.cfm?event=overview.process&ApplNo=205437"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-022-00767-7"},{"key":"e_1_2_6_28_1","volume-title":"Prescribing information","author":"OTEZLA (apremilast)","year":"2021"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keaa064"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-023714"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-208840"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2024-eular.2854"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.24130"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izy160"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40264-024-01454-0"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40264-016-0431-z"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1080\/1364557032000119616"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-021-01821-3"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.7326\/M18-0850"},{"key":"e_1_2_6_40_1","unstructured":"Covidence Systematic Review Software. Accessed August 14 2024.www.covidence.org"},{"key":"e_1_2_6_41_1","volume-title":"The Joanna Briggs Institute Reviewers\u2019 Manual 2015: Methodology for JBI Scoping Reviews","author":"The Joanna Briggs Institute","year":"2015"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15061707"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.405"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keab910"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.1177\/1759720X19899296"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.1942"},{"key":"e_1_2_6_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2024.01.019"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.14309\/01.ajg.0000705436.64452.7d"},{"key":"e_1_2_6_49_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2019-eular.5900"},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.1191\/0962280206sm433oa"},{"key":"e_1_2_6_51_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1556745"},{"key":"e_1_2_6_52_1","unstructured":"US Food and Drug Administration.Drug approval package: Xeljanz (tofacitinib) tablets. Published December 28 2012. Accessed August 14 2024.https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/nda\/2012\/203214orig1s000toc.cfm"},{"key":"e_1_2_6_53_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.105262"},{"key":"e_1_2_6_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2018.08.009"},{"key":"e_1_2_6_55_1","doi-asserted-by":"publisher","DOI":"10.1177\/1753495X211056211"},{"key":"e_1_2_6_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crtox.2024.100149"},{"key":"e_1_2_6_57_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-023-05398-z"}],"container-title":["Arthritis Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.25502","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T15:48:09Z","timestamp":1759420089000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr.25502"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,24]]},"references-count":56,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1002\/acr.25502"],"URL":"https:\/\/doi.org\/10.1002\/acr.25502","archive":["Portico"],"relation":{},"ISSN":["2151-464X","2151-4658"],"issn-type":[{"value":"2151-464X","type":"print"},{"value":"2151-4658","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,24]]},"assertion":[{"value":"2024-10-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}