Painkillers may Cause Problems in Conception

Use of painkillers and increased age may delay conception in people having inflammation of joints and spine.

Highlights:

Diseases which cause inflammation of joints and spine are called Spondyloarthritis (SpA)
In a recent study, 88 participants with mean age of 31.8 were who were trying to conceive; average time for conception was 16.1 months
Significant increase in time of conception for those regularly using painkillers (Nonsteroidal anti-inflammatory drugs) and increased age

In a new study presented by the American College of Rheumatology’s, it was seen that treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) and older age were associated with longer time to conception in spondyloarthritis patients.

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‘For patients suffering from inflammation of joints and spine (spondyloarthritis), pain killers and increased age might make conceiving a child quite difficult.’

What is Spondyloarthritis?

Spondyloarthritis (SpA) is a group of inflammatory diseases of the joints and spine, with a variety of clinical manifestations like chronic back pain, alternate buttock pain. Although SpA is prevalent among people of almost always below the age of 45, little is known about the effect of the disease and its treatment on fertility.

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Participants of the study having joint diseases

Study participants included 88 patients, with a mean age of 31.8 (plus or minus 5 years), who were trying to conceive and were enrolled in the French multi-center GR2 cohort from 2015 to June 2021.

“The GR2 cohort follows patients from preconception or the first trimester of pregnancy until one year after delivery,” explains Sabrina Hamroun, M.D., an associate professor at Cochin University Hospital, Paris, France, and the study’s lead author. “The sociodemographic characteristics of the patients, exposures to various treatments and disease activity are regularly recorded for patients during follow-up. The objective of this cohort is to evaluate the factors associated with time to conception and obstetric morbidity in women with chronic inflammatory rheumatic diseases, among other pathologies.”

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Participants of the study having joint diseases

The study’s primary endpoint was time to conception and the secondary endpoints were the number of sub-fertile patients (their time to conception was more than 12 months or they did not become pregnant) as well as the number who used conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) and biologics during the preconception period.

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Data regarding painkillers and its association with conceiving

The data showed that 56 (63.6%) of the 88 participants had a pregnancy during follow-up, with 40 (45%) identified as subf-ertile. In this group, the median time-to-conception was 16.1 months. Twenty-three patients were treated with NSAIDs, eight with corticosteroids, twelve with csDMARDs and sixty-one with biologics. The study model, adjusted for age, body mass index, disease duration and activity, smoking, type of SpA and medication during preconception, showed a statistically significant increase in time to conception with NSAID use and older age.

Other Factors Affecting Conception

Dr. Hamroun notes that because study participants were drawn from tertiary centers, these findings may not be representative of all women with SpA in France of child-bearing age since patients with less severe forms of the disease are often managed in outpatient settings. And she says, “We cannot rule out NSAIDs as a proxy for disease activity. In addition, there were no data available on quality of life and frequency of sexual intercourse, which are variables that may impact time to conception.”

Impact of Painkillers on Women Trying to Conceive

Still, Dr. Hamroun says, “The study shows the impact of NSAIDs use in women with SpA and their ability to conceive. These results are also consistent with the mechanism of action of NSAIDs whose deleterious effect on fertilization has been demonstrated in other diseases. Indeed, the significant increase in time to conception argues for the cautious use — or supervised discontinuation — of NSAIDs in women with SpA who have difficulties conceiving.”

Source-Medindia