{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T05:49:53Z","timestamp":1776232193409,"version":"3.50.1"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:00:00Z","timestamp":1762473600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Health Labour Sciences Research Grant","award":["23FA1009"],"award-info":[{"award-number":["23FA1009"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine changes in rheumatoid arthritis (RA) medication prescriptions during the peri-delivery period, and to explore recent RA prescription trends using a Japanese claims database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective observational cohort study used an insurance claims database provided by JMDC Inc. We identified pregnant women with RA who delivered between April 2018 and October 2023. The outcome was the initiation or resumption of intensive treatment after delivery, defined as new or restarting of biologic disease modifying anti-rheumatic drugs (DMARDs), targeted synthetic DMARDs, oral corticosteroids (OCS), or methotrexate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 229 mothers with RA and 246 deliveries. Intensive treatment was initiated in 55 (22.4%) deliveries. Continuation of the same prescription from before delivery was observed in 106 (43.1%) deliveries. The most frequent new prescription postpartum was methotrexate in 18 (7.3%) deliveries. OCS were the most commonly prescribed medications throughout the observation period. Tumour necrosis factor alpha inhibitors were prescribed at similar rates as OCS before pregnancy and in the first trimester, but declined during the second and third trimesters, and returned postpartum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The number of deliveries that required intensive treatment postpartum was lower than in previous studies. Our results suggest that the latest guidelines for pregnant women with RA help control disease activity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/mr\/roaf106","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T13:20:02Z","timestamp":1762435202000},"page":"345-352","source":"Crossref","is-referenced-by-count":0,"title":["Changes in rheumatoid arthritis medication in pregnancy: a retrospective observational study using a Japanese claims database"],"prefix":"10.1093","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1091-8311","authenticated-orcid":false,"given":"Yuichi","family":"Shiotsuki","sequence":"first","affiliation":[{"name":"Graduate School of Health Management, Keio University , Fujisawa-shi ,","place":["Japan"]},{"name":"Real World Evidence Division, Pharmaceutical Business Unit, JMDC Inc. , Tokyo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5527-7574","authenticated-orcid":false,"given":"Miho","family":"Iida","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Public Health, Keio University School of Medicine , Tokyo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9999-5366","authenticated-orcid":false,"given":"Shiori","family":"Tsuchiya","sequence":"additional","affiliation":[{"name":"Real World Evidence Division, Pharmaceutical Business Unit, JMDC Inc. , Tokyo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7705-9903","authenticated-orcid":false,"given":"Minako","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Public Health, Keio University School of Medicine , Tokyo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6487-8934","authenticated-orcid":false,"given":"Daisuke","family":"Sugiyama","sequence":"additional","affiliation":[{"name":"Graduate School of Health Management, Keio University , Fujisawa-shi ,","place":["Japan"]},{"name":"Faculty of Nursing and Medical Care, Keio University , Fujisawa-shi ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,11,7]]},"reference":[{"key":"2026041500571300200_ref1","author":"","journal-title":"Epidemiology of the Rheumatic Diseases"},{"key":"2026041500571300200_ref2","doi-asserted-by":"publisher","first-page":"1676","DOI":"10.1111\/1756-185X.13974","article-title":"Prevalence of patients with rheumatoid arthritis and age-stratified trends in clinical characteristics and treatment, based on the National Database of health insurance claims and specific health 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intermittent hydrarthrosis","volume":"13","author":"Hench","year":"1938","journal-title":"Mayo Clin Proc"},{"key":"2026041500571300200_ref6","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1136\/annrheumdis-2015-208840","article-title":"The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation","volume":"75","author":"Skorpen","year":"2016","journal-title":"Ann Rheum Dis"},{"key":"2026041500571300200_ref7","doi-asserted-by":"publisher","first-page":"413","DOI":"10.2188\/jea.je20090066","article-title":"Development of a database of health insurance claims: standardization of disease classifications and anonymous record linkage","volume":"20","author":"Kimura","year":"2010","journal-title":"J Epidemiol"},{"key":"2026041500571300200_ref8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3820\/jjpe.29.e1","article-title":"A method for identifying pregnant women by linking mothers and Newborns in the JMDC database and 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A systematic review and Metaanalysis","volume":"46","author":"Jethwa","year":"2019","journal-title":"J Rheumatol"},{"key":"2026041500571300200_ref19","volume-title":"Research Team: \u201cCreating Treatment Guidelines for Women with Rheumatoid Arthritis (RA) and Inflammatory Bowel Disease (IBD) Who Are Considering Pregnancy and Childbirth\u201d. Zenshinsei Eritemato-Desu (SLE), Kansetsu Riumachi (RA), Jakunenseitokuhatsuseikansetsuen (JIA) ya Ensyouseichoushikkan (IBD) Rikanjoseikanja no Ninshin, Syussan Wo Kangaeta Chiryoushishin (in Japanese)"},{"key":"2026041500571300200_ref20","doi-asserted-by":"publisher","first-page":"e495","DOI":"10.1016\/S2665-9913(23)00213-8","article-title":"Biosimilars and the era of interchangeability","volume":"5","author":"The Lancet Rheumatology","year":"2023","journal-title":"Lancet Rheumatol"},{"key":"2026041500571300200_ref21","volume-title":"Rheumatologists Are Prescribing More Biosimilars","author":"Generics and biosimilars Initiative"},{"key":"2026041500571300200_ref22","volume-title":"Reiwa 2 Nen Iryoushisetu (Doutai, Seitai) Tyousa (Kakuteisuu), Byouinhoukoku no Gaikyou","author":"Office of Health Statistics, Office of the Councillor, Director-General for Policy Planning","year":"2020"},{"key":"2026041500571300200_ref23","doi-asserted-by":"publisher","first-page":"1407","DOI":"10.1177\/0961203319877258","article-title":"Pregnancy outcomes in women with rheumatic diseases: a real-world observational study in Japan","volume":"28","author":"Sugawara","year":"2019","journal-title":"Lupus."},{"key":"2026041500571300200_ref24","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph15020369","article-title":"Different risk factors for very low birth weight, term-small-for-gestational-age, or preterm birth in Japan","volume":"15","author":"Tamura","year":"2018","journal-title":"Int J Environ Res Public Health"},{"key":"2026041500571300200_ref25","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1136\/annrheumdis-2020-219547","article-title":"Modern treatment approach results in low disease activity in 90% of pregnant rheumatoid arthritis patients: the PreCARA study","volume":"80","author":"Smeele","year":"2021","journal-title":"Ann Rheum Dis"}],"container-title":["Modern Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/mr\/advance-article-pdf\/doi\/10.1093\/mr\/roaf106\/65240888\/roaf106.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mr\/article-pdf\/36\/3\/345\/65240888\/roaf106.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mr\/article-pdf\/36\/3\/345\/65240888\/roaf106.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T04:57:21Z","timestamp":1776229041000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/mr\/article\/36\/3\/345\/8316757"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,7]]},"references-count":25,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,11,7]]},"published-print":{"date-parts":[[2026,4,13]]}},"URL":"https:\/\/doi.org\/10.1093\/mr\/roaf106","relation":{},"ISSN":["1439-7595","1439-7609"],"issn-type":[{"value":"1439-7595","type":"print"},{"value":"1439-7609","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,5]]},"published":{"date-parts":[[2025,11,7]]}}}