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Remission oder inaktive Erkrankung sind somit das Ziel, das im Hinblick auf die m\u00fctterliche Gesundheit und auf den Schwangerschaftsausgang zu verfolgen ist. Die antirheumatische Therapie sollte gem\u00e4\u00df internationalen Empfehlungen bereits bei geplanter Schwangerschaft angepasst werden. Zu den erwiesenen teratogenen Antirheumatika z\u00e4hlen Mycophenolat, Methotrexat, Cyclophosphamid und Thalidomid, diese m\u00fcssen ca.\u00a03\u00a0Monate vor der Konzeption abgesetzt werden. Leflunomid ist ein schwaches humanes Teratogen, das vor einer Schwangerschaft abgesetzt und medikament\u00f6s ausgewaschen werden soll. Aufgrund einer unzureichenden Datenlage sollten Apremilast und JAK(Januskinase)-Inhibitoren sowie neuere Biologika in der Schwangerschaft vermieden werden. Als kompatibel mit einer Schwangerschaft gelten die Antirheumatika Hydroxychloroquin, Sulfasalazin, Azathioprin, Ciclosporin, Tacrolimus, Colchicum, nichtselektive NSAR (nichtsteroidale Antirheumatika), niedrig dosiertes Prednison\/Prednisolon sowie TNF(Tumor-Nekrose-Faktor)-Hemmer. Auch in der Stillzeit sind diese Antirheumatika m\u00f6glich, dar\u00fcber hinaus auch andere Biologika wie Rituximab. In einem Beratungsgespr\u00e4ch bei Schwangerschaftsplanung sollten mit der Patientin der Nutzen sowie die internationalen Empfehlungen zur schwangerschaftskompatiblen Antirheumatikatherapie gegen\u00fcber den fetomaternalen Risiken einer aktiven Erkrankung besprochen werden, um eine gemeinsame Entscheidungsfindung zu erm\u00f6glichen.<\/jats:p>","DOI":"10.1007\/s00393-021-01095-z","type":"journal-article","created":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T14:02:41Z","timestamp":1632837761000},"page":"716-725","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Aktuelles zur antirheumatischen Therapie bei Kinderwunsch, Schwangerschaft und Stillzeit","Current aspects of antirheumatic therapy in pregnancy planning, during pregnancy and breastfeeding"],"prefix":"10.1007","volume":"80","author":[{"given":"Celine","family":"H\u00e4feli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frauke","family":"F\u00f6rger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,9,28]]},"reference":[{"issue":"4","key":"1095_CR1","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1002\/acr.24130","volume":"72","author":"LR Sammaritano","year":"2020","unstructured":"Sammaritano\u00a0LR, Bermas\u00a0BL, Chakravarty\u00a0EE, Chambers\u00a0C, Clowse\u00a0MEB, Lockshin\u00a0MD et\u00a0al (2020) 2020 American College of Rheumatology guideline for the management of reproductive health in rheumatic and musculoskeletal diseases. 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