Evidence map›Paper›PMID 40678818›Full record

ArticleTherapeutic advances in musculoskeletal disease2025

Impact of conflicting information on the use of antirheumatic drugs in pregnancy and breastfeeding: perspectives of healthcare providers from the global PRAISE survey.

Karen Schreiber, Christine Graversgaard, Ioannis Parodis, Nancy Agmon-Levin, Silvia Aguilera, Aleksandra Antovic, George K Bertsias, Ilaria Bini, Anca Bobirca, Susana Capela and 37 more

Abstract read
In one paragraph

Article in Therapeutic advances in musculoskeletal disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Introducing theInternational journal of women's dermatology · 2026
    Article
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  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

47 authors.

Karen SchreiberDanish Center for Expertise in Rheumatology, Danish Hospital for Rheumatic Diseases, Engelshøjgade 9, Sønderborg 6400, Denmark.
Christine GraversgaardDanish Center for Expertise in Rheumatology, Danish Hospital for Rheumatic Diseases, Sønderborg, Denmark.ORCID https://orcid.org/0000-0002-7032-0435
Ioannis ParodisDivision of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.ORCID https://orcid.org/0000-0002-4875-5395
Nancy Agmon-LevinThe Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.
Silvia AguileraDepartment of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.ORCID https://orcid.org/0000-0001-6021-5335
Aleksandra AntovicDivision of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.ORCID https://orcid.org/0000-0002-7421-5069
George K BertsiasDepartment of Rheumatology and Clinical Immunology, School of Medicine, University of Crete, Heraklion, Greece.ORCID https://orcid.org/0000-0001-5299-1406
Ilaria BiniEULAR Young PARE, Avellino, Italy.
Anca BobircaInternal Medicine and Rheumatology, Dr. I. Cantacuzino Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Susana CapelaRheumatology Department, Hospital de Santa Maria, U.L.S. Santa Maria, Lisbon, Portugal.
Ricard CerveraDepartment of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Barcelona, Spain.
Nathalie Costedoat-ChalumeauCentre de Référence Maladies Auto-Immunes et Systémiques Rares, Hôpital Cochin, and Université Paris Cité, Paris, France.
Radboud DolhainDepartment of Rheumatology, Erasmus University Medical Center, Rotterdam, Netherlands.
Oseme EtomiDepartment of Obstetric Medicine, Guy's & St Thomas' Foundation Trust, London, UK.
Julia FlintRheumatology, The Robert Jones and Agnes Hunt Orthopaedic Hospital, NHS Foundation Trust, Oswestry, UK.
Joao Eurico FonsecaRheumatology Department, Hospital de Santa Maria, U.L.S. Santa Maria, Lisbon, Portugal.
Ruth Fritsch-StorkHealth Care Center Mariahilf, ÖGK and Rheumatology Department at the Sigmund Freud Private University, Vienna, Austria.
Frauke FörgerDepartment of Rheumatology, Cantonal Hospital St Gallen, St Gallen, Switzerland.
Ian GilesDivision of Medicine, Department of Ageing, Rheumatology and Regenerative Medicine, University College London, London, UK.
Bethan GouldenDivision of Medicine, Department of Ageing, Rheumatology and Regenerative Medicine, University College London, London, UK.ORCID https://orcid.org/0000-0001-9701-190X
Carina Götestam SkorpenDepartment of Health Sciences, Norwegian University of Science and Technology, Ålesund, Norway.
Iva GunnarssonDivision of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
Latika GuptaDepartment of Rheumatology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK.ORCID https://orcid.org/0000-0003-2753-2990
Hege Svean KoksvikNorwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, Rheumatology Department, St Olavs Hospital-Trondheim University Hospital, Trondheim, Norway.
Louise LindeCopenhagen Research Center for Autoimmune Connective Tissue Diseases, Lupus and Vasculitis Clinic, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Jacob LykkeDepartment of Gynecology, Fertility and Obstetrics, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Yvette MeissnerGerman Rheumatology Research Center, Epidemiology and Health Services Research, Berlin, Germany.ORCID https://orcid.org/0000-0003-0147-4112
Anna MoltoINSERM (U1153), Center for Research on Epidemiology and Statistics, Department of Rheumatology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris-Cité, Paris, France.ORCID https://orcid.org/0000-0003-2246-1986
Louise MooreRheumatic and Musculoskeletal Disease Unit, Our Lady's Hospice and Care Services, Harold's Cross, Dublin, Ireland.
Marta MoscaRheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Catherine Nelson-PiercyDepartment of Obstetric Medicine, Guy's & St Thomas' Foundation Trust, London, UK.
Luis Fernando Perez-GarciaDepartment of Rheumatology, Erasmus University Medical Center, Rotterdam, Netherlands.ORCID https://orcid.org/0000-0002-8958-9493
Luigi RaioDepartment of Obstetrics and Gynecology, Inselspital, University Hospital of Bern, Bern, Switzerland.
Ane Lilleoere RomDepartment of Gynecology, Fertility and Obstetrics, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Amihai RottenstreichDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra/Northwell, New York City, NY, USA.
Muna SalehDivision of Inflammation and Infection/Rheumatology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.ORCID https://orcid.org/0000-0002-4836-6373
Savino SciasciaDepartment of Clinical and Biological Sciences, Center for Research of Immunopathology and Rare Diseases, San Giovanni Hospital, University of Turin, Turin, Italy.
Anja StrangfeldGerman Rheumatology Research Center, Epidemiology and Health Services Research, Berlin, Germany.
Elisabet SvenungssonDivision of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
Maria G TektonidouRheumatology Unit, First Department of Propaedeutic and Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece.ORCID https://orcid.org/0000-0003-2238-0975
Angela TincaniRheumatology and Clinical Immunology Unit-ERN ReCONNET, ASST Spedali Civili, Brescia, Italy.ORCID https://orcid.org/0000-0003-4355-9333
Anne TroldborgDepartment of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.
Jelena VojinovicFaculty of Medicine, University of Nis, Clinic for Pediatrics, University Clinical Center Nis, Nis, Serbia.ORCID https://orcid.org/0000-0002-6701-3370
Anne VossDepartment of Rheumatology, Odense University Hospital, Odense, Denmark.ORCID https://orcid.org/0000-0001-6582-2636
Marianne WalleniusCentre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, University of Manchester, Manchester, UK.
Nuria Zuniga-SerranoLupus Europe, Brussels, Belgium.
Laura AndreoliDanish Center for Expertise in Rheumatology, Danish Hospital for Rheumatic Diseases, Sønderborg, Denmark.ORCID https://orcid.org/0000-0002-9107-3218

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Treating rheumatic musculoskeletal diseases (RMDs) during pregnancy and breastfeeding presents significant complexities, mainly due to inconsistencies between the clinical guidance documents and the reference safety information, including the summary of product characteristics (SmPC) and the patient information leaflets (PIL). Objectives: To assess healthcare professionals' (HCPs) prescribing behaviors, comfort levels, and challenges when advising patients, focusing on discrepancies between clinical guidance documents and SmPC/PIL. Design: Online survey entitled PRAISE (Perception of healthcare providers Regarding Antirheumatics in pregnancy and breastfeeding: advice, Information and patient perSpEctives) and disseminated through HCPs groups and social media. Methods: A cross-sectional survey was conducted among 414 HCPs globally. Respondents were divided into prescribers ( Results: Prescribers were more likely than non-prescribers to feel comfortable discussing medication safety during pregnancy. Most prescribers found clinical guidance documents useful, with 48% rating them as "very useful" and 38% as "extremely useful." In case of conflicting information between clinical guidance documents and SmPC/PIL, 58% of HCPs reported that it caused confusion and tension in patient-doctor relationships, and almost 20% of them are "likely" or "very likely" to discontinue ongoing treatment. Clear communication and shared decision-making were the most common strategies used to address patient concerns. Conclusion: HCPs often face significant challenges when advising patients with RMDs on the use of medications during pregnancy and breastfeeding. Conflicting information between clinical guidance documents and SmPC/PIL can disrupt patient-doctor relationship and lead to treatment discontinuation, with potential consequences on maternal disease control. Improved alignment between clinical guidance documents and the SmPC/PIL could enhance patient care and prevent confusion among HCPs and patients.

Indexed as

antirheumatic medicationsbreastfeedinglactationpatient information leafletpregnancysummary of product characteristics

Identifiers

PMID40678818
PMCPMC12267951

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.