Which medication is considered the treatment of choice for rheumatoid arthritis during pregnancy?

The treatment of choice for rheumatoid arthritis during pregnancy is glucocorticoids. These medications are beneficial because they effectively reduce inflammation and suppress the immune response, which is crucial in managing rheumatoid arthritis symptoms. Glucocorticoids can be used in pregnancy because they have a well-established safety profile and do not have the same contraindications or risks associated with several other options.

During pregnancy, the risk to the fetus needs to be carefully considered, and while some DMARDs, nonsteroidal anti-inflammatory drugs (NSAIDs), and biologics may be used in certain circumstances, glucocorticoids are preferred due to their efficacy and lower risk of adverse effects on fetal development when used at the appropriate dosages. For instance, while NSAIDs can be effective for pain relief in rheumatoid arthritis, their use, especially in the third trimester, is associated with risks such as premature closure of the ductus arteriosus. Biologics, although beneficial for some patients, may carry risks of infections and other complications during pregnancy. Therefore, glucocorticoids stand out as the most widely accepted therapeutic option for managing rheumatoid arthritis in pregnant patients.