Worried About Meds and Pregnancy 
from Melissa

Ed, Somebody referred me to FlakeHQ and I think it’s great!  I am 28 and have had psoriasis for about 6 years.  Two years ago, the Dr. put me on methotrexate and I have been 97% clear ever since — with the exception of a couple of spots which I think are permanent and can never be removed. 

I was wondering if you could help me with a problem/dilemma I am having.  I am looking for some answers from experienced psoriasis sufferers.  It has to do with pregnancy and medications.  Now I realize that you might not have personal experience, but maybe your readers can help or maybe you have spoken to people about this before.

I know that you should definitely not get pregnant while on MTX (methotrexate), I also know that the doctors say you should be off of it at least 6 months before you try having kids.  I am looking for answers to the following questions. 

Do you know anyone who was on MTX before they became pregnant and stopped to become pregnant?  If so, how was the baby?  Do you know anyone who was on cyclosporine while trying to become pregnant?  Is that harmful for the baby?

My problem is I read a million different viewpoints about cyclosporine and I am just looking for women with psoriasis who might have answers to these questions.  Please let me know if you have any insight. 

I truly enjoyed reading your diaries from when you were on cyclosporine and MTX.  Sometimes we really need to be reminded that we are not the only one having these problems.   I was recently diagnosed with psoriatic arthritis in my knee — which scares me considering I take 6 pills of MTX every week.  I can only imagine the pain I’ll be in when I have to go off.  I also have the arthritis in my pinky and I am sure I will lose a joint as soon as I go off the MTX.  The MTX has saved my other fingers for now, but I know it’s just waiting.  My father has psoriatic arthritis pretty bad in his fingers.  All of his joints are stiff and he has had surgery to move bones from his toes to his fingers.  He has managed to play tennis and golf almost everyday.  It’s always funny to see his golf club fly out of his hands into the water because he lost his grip.  I laugh because I have to — otherwise it would remind me of what I may be like 20 years from now.   Thanks for making a difference.  I look forward to being an active visitor to FlakeHQ from now on. Thanks  -Melissa

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Ed’s Response:  Glad you were referred to us, Melissa.  If you are a member of the National Psoriasis Foundation you can download a brochure from their website titled “Conception, Pregnancy & Psoriasis.”  According to this brochure, MTX poses no problems if it isn’t used at conception or during pregnancy.  Cyclosporine does not appear to pose a “major fetal risk for pregnant women.  A worldwide registry of transplant patients (cyclosporine ... is used in organ transplant cases) treated with the drug during pregnancy did not show an increased rate of birth defects, although low birth weight and premature birth were traced to cyclosporine use.”

I appreciate your anxiety with regard to the arthritis and what might happen when you go off the MTX.  I’m hoping to go back on MTX very soon because my PA is flaring again.  I cringe to think of what it might be like to go through a PA flare during nine months of pregnancy.  Hopefully some other FlakeHQer who has personal experience with this (MTX, PA and pregnancy) will write back.

In the meantime, I recommend you visit the NPF website and post another inquiry in the member forum (assuming you are or will become a member).  Also, post an inquiry in the Psoriatic Arthritis Forum at PsorHeads (you can jump there from the hyperlink in the contents bar at the top of this page).

If you search on the word “pregnancy” here (click on Search, above, to go back to the home page) you will get several references to email in the archives.  Many women experience a complete relapse of their P symptoms while pregnant.  It’s unfortunate that we have no test you could take in advance to see if that’s going to be your experience.

Let us know how things progress and what other FlakeHQers have to say.  We look forward to hearing from you again.  -Ed

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